Individual
DR. TARA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-2370
Mailing address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD441615
PA
207L00000X
Anesthesiology Physician
MT184760
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253341
—
NJ
05
—
102553934
—
PA
Enumeration date
02/21/2008
Last updated
03/24/2015
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