Individual
NICOLE MARIE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
5 E 98TH ST, NEW YORK, NY 10029-6501
(212) 241-7640
Mailing address
17 MALLARD DR, GREENWICH, CT 06830-6707
(203) 651-9178
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
383523
NY
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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