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Individual

KATHLEEN A KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
19 WOODLAND ST, STE 35, HARTFORD, CT 06105-2372
(860) 525-1234
(860) 278-8782
Mailing address
19 WOODLAND ST, STE 47, HARTFORD, CT 06105-2372
(860) 525-4005
(860) 525-4839

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
026843
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004244738
AETNA
05
001268433
CT
01
00126843301
ANTHEM BCBS
01
010026843CT03
ANTHEM BCBS
01
060052425
RAILROAD MEDICARE
01
2083418
AETNA
01
708620
CONNECTICARE
CT
01
HAS544
OXFORD
CT
Enumeration date
08/30/2005
Last updated
07/07/2015
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