Individual
DR. KEVIN JONATHAN ROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5958 DELAFIELD AVE, BRONX, NY 10471-1608
(914) 512-0938
Mailing address
5958 DELAFIELD AVE, BRONX, NY 10471-1608
(914) 512-0938
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
003515
NY
213E00000X
Podiatrist
25MD00152500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003515
LICENSE
NY
01
—
25MD00152500
STATE LICENSE
NJ
01
—
3090
STATE LICENSE
CA
Enumeration date
01/11/2018
Last updated
01/11/2018
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