Ilene Fennoy, MD
Pediatrics, Pediatric Endocrinology in New York, NY. Individual provider (NPI-1).
Details
- NPI
- 1770575862
- Entity type
- Individual (NPI-1)
- Name
- Ilene Fennoy
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 16, 2005
- Certification date
- Sep 22, 2026
- Last updated
- Sep 22, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PEDIATRIC MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0205X | Pediatrics, Pediatric Endocrinology | 122361 | NY | Yes |
| 208000000X | Pediatrics | 122361 | NY |
Practice location
3959 BroadwayChn 106
New York, NY 10032
Phone 212-305-6559 · Fax 212-305-4778
Mailing address
630 W 168th StPh5e 522
New York, NY 10032
Phone 212-305-6559 · Fax 212-305-4778
Other practice locations
Hawthorne, NY 10532-2194
Phone 914-919-9280 · Fax 914-366-3407
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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