Provider Demographics
NPI:1083700702
Name:CARTAXO, KENNETH WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:WILLIAM
Last Name:CARTAXO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:435 SOUTH ST SUITE 160
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-971-4686
Mailing Address - Fax:973-290-7085
Practice Address - Street 1:435 SOUTH ST SUITE 160
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-971-4686
Practice Address - Fax:973-290-7085
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA043161146D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant