Provider Demographics
NPI:1780845750
Name:KENESS, NANCY SUE (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:SUE
Last Name:KENESS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4008
Mailing Address - Country:US
Mailing Address - Phone:718-768-7501
Mailing Address - Fax:718-768-7502
Practice Address - Street 1:362 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4008
Practice Address - Country:US
Practice Address - Phone:718-768-7501
Practice Address - Fax:718-768-7502
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-22
Last Update Date:2008-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0034681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0034681OtherNY STATE LICENSE