Individual
TAYLOR KENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 RICHARD AVE, ISLIP TERRACE, NY 11752-2712
(631) 627-0122
Mailing address
22 RICHARD AVE, ISLIP TERRACE, NY 11752-2712
(631) 627-0122
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
09/26/2019
Last updated
05/01/2020
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