Provider Demographics
NPI:1083870588
Name:DULNUAN, KENNETH RASALAN (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:RASALAN
Last Name:DULNUAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8813 RIDGE BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5613
Mailing Address - Country:US
Mailing Address - Phone:315-395-8014
Mailing Address - Fax:
Practice Address - Street 1:501 SEAVIEW AVE STE 300
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3400
Practice Address - Country:US
Practice Address - Phone:718-226-3202
Practice Address - Fax:718-226-7091
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA10692000207UN0901X, 207RC0000X, 207RA0001X, 207R00000X
NY338375207RA0001X, 207RC0000X, 207R00000X
KY45759207R00000X, 207RA0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ710491Medicaid
KY7100273980Medicaid
IN300016626Medicaid