Individual
ERIN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
67 HOME AVE, RUTHERFORD, NJ 07070-1727
(646) 470-3672
Mailing address
370 CONVENT AVE APT 4B, NEW YORK, NY 10031-4225
(773) 636-5715
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
006692
NY
171100000X
Acupuncturist
Primary
25MZ00145700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006692
NEW YORK STATE ACUPUNCTURE LICENSE
NY
01
—
25MZ00145700
NEW JERSEY STATE ACUPUNCTURE LICENSE
NJ
Enumeration date
08/17/2020
Last updated
08/17/2020
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