Individual provider Active NPI

Deborah McKennell

  • Specialist
  • Seaford, NY
National Provider Identifier
1750801403
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
906829141 Issued in NY
Practice address
750 Hicksville Rd
Seaford, NY 11783-1328
Phone
(516) 520-6000
Fax
(516) 520-6000
NPI assigned
Jun 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 906829141 NY Primary

Addresses

Primary practice location

750 Hicksville Rd
Seaford, NY 11783-1328

Mailing address

2521 S Saint Marks Ave
Bellmore, NY 11710-5007
Phone (516) 749-2823

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

State licenses

LicenseStateTypeSpecialty
906829141NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1750801403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 S SAINT MARKS AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105007",
            "telephone_number": "516-749-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HICKSVILLE RD",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117831328",
            "telephone_number": "516-520-6000",
            "fax_number": "516-520-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNELL",
        "first_name": "DEBORAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "906829141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.