Provider Demographics
NPI:1396790259
Name:KENNETH MARCH, DPM, PLLC
Entity type:Organization
Organization Name:KENNETH MARCH, DPM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-283-9457
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005116213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1325390001Medicare NSC
NY54994BMedicare PIN