Individual
KENNEDY O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
416 BRIX PL, UNIONDALE, NY 11553-3079
(516) 492-1734
Mailing address
416 BRIX PL, UNIONDALE, NY 11553-3079
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
311544
NY
363LG0600X
Gerontology Nurse Practitioner
311544
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
F311544
NY
Other
Enumeration date
10/04/2023
Last updated
02/01/2024
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