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Individual

BRIAN KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
175 MEMORIAL HWY, SUITE 2-3, NEW ROCHELLE, NY 10801-5635
(914) 235-5354
(914) 235-5736
Mailing address
4175 VETERANS MEMORIAL HWY, SUITE 202, RONKONKOMA, NY 11779-7639
(631) 580-5200
(631) 580-5222

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
026707-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02856357
NY
Enumeration date
05/26/2006
Last updated
11/10/2009
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