Individual
KEVIN HENNESSY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
701 SENECA ST STE 646C, BUFFALO, NY 14210-1351
(716) 995-4450
Mailing address
206 LOVERING AVE, BUFFALO, NY 14216-1846
(716) 871-0580
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304561-1
NY
Other
Enumeration date
01/24/2007
Last updated
10/25/2019
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