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Individual

DR. BETTY J KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
106 CAMPUS AVE, LEWISTON, ME 04240-6019
(207) 755-3383
(207) 755-3285
Mailing address
PO BOX 1638, ALBANY, NY 12201-1638
(207) 777-4111
(207) 783-6660

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
009626
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
290100099
ME
Enumeration date
07/10/2006
Last updated
07/11/2011
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