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Contact Information

KENNWORTH EATON II, PA
240 W MONTAUK HWY
HAMPTON BAYS, NY11946-3510
 Phone: 631-728-4500
 Fax: 631-728-4564
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KENNWORTH EATON II · (Male)

NPI # 1891984548
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 10/18/2007
Last updated 06/07/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 006619
Hospital affiliation(s)
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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