Individual
DR. PAUL VINCENT KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
117 WATCHUNG AVE, 2ND FLOOR, MONTCLAIR, NJ 07043-1710
(973) 783-2984
(973) 783-5074
Mailing address
5 FAIRFIELD ST, MONTCLAIR, NJ 07042-4113
(973) 783-2984
(973) 783-5074
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
38919
NJ
2084P0804X
Child & Adolescent Psychiatry Physician
38919
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0224804
—
NJ
01
—
P00836064
RR MEDICARE
NJ
Enumeration date
06/03/2006
Last updated
08/19/2010
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