Provider Demographics
NPI:1558477141
Name:KUENZLER, KEITH ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ALAN
Last Name:KUENZLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:530 1ST AVE
Mailing Address - Street 2:SUITE 10W
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-7391
Mailing Address - Fax:212-263-6590
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:SUITE 10W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-7391
Practice Address - Fax:212-263-6590
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2318602086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02797822Medicaid