Active NPI
Kenneth Ihenetu, PHD, DABCC, FACB
- Clinical Laboratory Director (Non-physician)
- Delmar, NY
National Provider Identifier
1083075212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Laboratory Director (Non-physician)
- License
- IHENK1
- Practice address
- 785 Delaware Ave FL 1
Delmar, NY 12054-9713 - Phone
- (361) 944-9554
- NPI assigned
- Mar 16, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Laboratory Director (Non-physician) | 247ZC0005X | IHENK1 | NY | Primary |
Addresses
Primary practice location
785 Delaware Ave FL 1
Delmar, NY 12054-9713
Mailing address
785 Delaware Ave, FL1
Delmar, NY 12054
Phone (361) 944-9554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IHENK1 | NY | MD | Clinical Laboratory Director (Non-physician) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1083075212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "785 DELAWARE AVE, FL1",
"city": "DELMAR",
"state": "NY",
"postal_code": "12054",
"telephone_number": "361-944-9554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "785 DELAWARE AVE FL 1",
"city": "DELMAR",
"state": "NY",
"postal_code": "120549713",
"telephone_number": "361-944-9554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IHENETU",
"first_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "PHD, DABCC, FACB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-16",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "247ZC0005X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
"state": "NY",
"license": "IHENK1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delmar, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.