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Individual

MS. CAITLIN KENNY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
86 SCOOTER LN, HICKSVILLE, NY 11801-6436
(516) 524-0305
Mailing address
86 SCOOTER LN, HICKSVILLE, NY 11801-6436

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1191105
NY

Other

Enumeration date
09/27/2012
Last updated
09/27/2012
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