Individual
KENADEED HERSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 BERGEN STREET ROOM 1110, NEWARK, NJ 07103
(434) 466-1316
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R4559
TX
Other
Enumeration date
05/12/2014
Last updated
06/27/2018
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