Individual
DR. TIMOTHY H KENEFICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
126 MORGAN ST, STAMFORD, CT 06905-5431
(203) 327-1055
(203) 323-6177
Mailing address
126 MORGAN ST., THE PEDIATRIC CENTER, STAMFORD, CT 06905-5431
(203) 327-1055
(203) 323-6177
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
028872
CT
208000000X
Pediatrics Physician
163113
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001288720
—
CT
Enumeration date
08/03/2005
Last updated
04/11/2014
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