Individual
DR. KENNETH TREADWELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1387 CLINTON AVE, IRVINGTON, NJ 07111-1442
(973) 372-1441
(973) 372-6019
Mailing address
1387 CLINTON AVE, IRVINGTON, NJ 07111-1442
(973) 372-1441
(973) 372-6019
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA03828700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA03828700
STATE LIC NR
NJ
05
—
3369803
—
NJ
Enumeration date
02/25/2006
Last updated
06/25/2010
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