Derese Keneni

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

715453 Issued in NY

Practice address

1575 Odell St
1G
Bronx, NY 10462-7053

Phone

(646) 236-4884

NPI assigned

Aug 31, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1912453796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 ODELL STREET",
            "address_2": "1G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10462",
            "telephone_number": "646-236-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 ODELL ST",
            "address_2": "1G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104627053",
            "telephone_number": "646-236-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENENI",
        "first_name": "DERESE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "715453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Kemp
• Colette Jeannine Kemta Kelbe, LPN
• Wendy Kendall
• Deborah Ann Kendrick, M.D.
• Faith Naomi Kendrick
• Flore Kengmeni
• Nathali Kengne-Tene
• David Kenison, DO
• Anshel Kenkare, MD
• Skyler Kennamer, OTD

• Registered Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.