Individual
VAN KENYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
185 S ORANGE AVE, NEWARK, NJ 07103-2757
(973) 972-6049
Mailing address
185 S ORANGE AVE, NEWARK, NJ 07103-2757
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
311462
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2017
Last updated
03/06/2026
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