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Individual

KEVIN KILLEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
77 HOSPITAL AVENUE, PITTSFIELD, MA 01201
(413) 662-2486
(413) 662-2102
Mailing address
725 NORTH ST, PITTSFIELD, MA 01201-4109
(413) 881-5427
(413) 496-6836

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
8935
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0109136Y0NH01
BLUE CROSS/BLUE SHIELD
NH
01
24P100
MVP
NH
01
28550
BLUE CROSS/BLUE SHIELD
VT
05
30008498
NH
01
AA37880
HAVARD PILGRIM HEALTHCARE
NH
05
ORE2655
VT
Enumeration date
03/03/2006
Last updated
08/23/2010
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