Provider Demographics
NPI:1598046906
Name:KENAWY, SALLY (MD)
Entity Type:Individual
Prefix:DR
First Name:SALLY
Middle Name:
Last Name:KENAWY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 LENOX RD
Mailing Address - Street 2:BOX 49
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2017
Mailing Address - Country:US
Mailing Address - Phone:718-270-1480
Mailing Address - Fax:
Practice Address - Street 1:445 LENOX RD
Practice Address - Street 2:BOX 49
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2017
Practice Address - Country:US
Practice Address - Phone:718-270-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program