Individual
ANNE M KENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, UCONN/GERIATRIC ASSOCIATES, FARMINGTON, CT 06030-0001
(860) 679-8400
(860) 679-1867
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
030589
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043293780
—
CT
Enumeration date
11/28/2005
Last updated
03/12/2014
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