Organization
THE DR. KENNY CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNY HASIJA (PRESIDENT)
(508) 764-6166
Entity
Organization
Contact information
Practice address
256 HAMILTON ST, SOUTHBRIDGE, MA 01550
(508) 764-6166
Mailing address
256 HAMILTON ST, SOUTHBRIDGE, MA 01550
(508) 764-6166
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35946
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9725229
—
MA
Enumeration date
04/18/2008
Last updated
04/18/2008
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