Provider Demographics
NPI:1619971355
Name:ZWEIG, KENNETH EDMUND (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:EDMUND
Last Name:ZWEIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WILTON CIR
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5207
Mailing Address - Country:US
Mailing Address - Phone:845-708-5967
Mailing Address - Fax:845-746-4196
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4812
Practice Address - Country:US
Practice Address - Phone:845-568-2827
Practice Address - Fax:845-568-2851
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206521207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01892259Medicaid
NY01892259Medicaid
NY793971Medicare PIN
NY793972Medicare PIN