Individual
KENNETH J MINTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
RIVERSIDE ASSOCIATES IN ANESTHESIA, 40 FRONT STREET, BINGHAMTON, NY 13905
(607) 722-7264
(607) 722-7869
Mailing address
RIVERSIDE ASSOCIATES IN ANESTHESIA, 40 FRONT STREET, BINGHAMTON, NY 13905
(607) 722-7264
(607) 722-7869
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
181411
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01191377
—
NY
01
—
CAN131411
WORKERS COMP
NY
Enumeration date
10/10/2005
Last updated
07/08/2007
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