Individual
SEAN MICHAEL KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
14 HUDSON AVENUE, ADIRONDACK ENT, GLENS FALLS, NY 12801-4363
(518) 926-1380
(518) 926-1385
Mailing address
100 PARK STREET, GLENS FALLS HOSPITAL - CREDENTIALING, GLENS FALLS, NY 12801-4413
(518) 926-5924
(518) 926-6983
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
242492
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02879821
—
NY
01
—
P00471826
RR MEDICARE
NY
Enumeration date
01/22/2007
Last updated
08/30/2024
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