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Individual

DR. KENNETH V. MASTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 472-4471
Mailing address
2 WHITE HORSE PIKE, HADDON HEIGHTS, NJ 08035-1294
(856) 310-0042
(856) 310-0092

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD047765L
PA
2084P0805X
Geriatric Psychiatry Physician
Primary
25MA06269400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6917007
NJ
Enumeration date
06/22/2006
Last updated
09/29/2023
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