Individual
DR. KIMBERLY FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
211725
NY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME129417
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02392276
—
NY
01
—
577Y61
EMPIRE BC.BS
NY
01
—
7858179
AETNA
NY
Enumeration date
06/15/2006
Last updated
09/22/2016
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