Individual
MR. KEVIN KILKENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
400 MONTAUK HWY STE 103, WEST ISLIP, NY 11795-4429
(631) 661-3700
(631) 661-3749
Mailing address
400 MONTAUK HWY STE 103, WEST ISLIP, NY 11795-4429
(631) 661-3700
(631) 661-3749
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002228-1
NY
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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