Provider Demographics
NPI:1780644211
Name:MARCH, KENNETH (DPM)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:MARCH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 PURITAN DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-3335
Mailing Address - Country:US
Mailing Address - Phone:518-283-9457
Mailing Address - Fax:518-283-9459
Practice Address - Street 1:27 W SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:WYNANTSKILL
Practice Address - State:NY
Practice Address - Zip Code:12198-7958
Practice Address - Country:US
Practice Address - Phone:518-283-9457
Practice Address - Fax:518-283-9459
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005116213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01668744Medicaid
NY1514340001Medicare NSC
NY01668744Medicaid
NY54994BMedicare ID - Type Unspecified