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Individual

DR. DEXTER ANTHONY MCKENZIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
490 NEW YORK AVE, SUITE LB1, BROOKLYN, NY 11225-4264
(718) 613-1500
(718) 613-1444
Mailing address
942 ROCKAWAY AVE, BROOKLYN, NY 11212-5237
(718) 613-1500
(718) 613-1444

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
180953
NY
208000000X
Pediatrics Physician
180953
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01395399
NY
Enumeration date
07/19/2006
Last updated
08/12/2014
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