Individual
DR. THOMAS MICHAEL KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-5437
Mailing address
622 W 168TH ST STE HP-104, NEW YORK, NY 10032-3720
(212) 305-4541
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C1-0011460
DE
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
293817
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2012
Last updated
03/10/2023
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