Individual
KEVIN P LENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 GRAHAM AVE, CORTLAND, NY 13045-2452
(607) 753-2011
Mailing address
16 HARGROVE DR, STONY BROOK, NY 11790-2306
(631) 848-1152
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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