Individual
KENNETH LAROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
500 EAST 83RD ST, 4A, NEW YORK, NY 10028-7391
(212) 979-6387
Mailing address
500 EAST 83RD ST, 4A, NEW YORK, NY 10028-7391
(212) 979-6387
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
40-401042
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03718774
—
NY
Enumeration date
02/13/2017
Last updated
02/13/2017
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