Individual
DR. MARY JO KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
215 E 95TH ST, SUITE M, FIRST FLOOR, NEW YORK, NY 10128-4077
(212) 996-8000
(212) 348-1260
Mailing address
215 E 95TH ST, SUITE M, FIRST FLOOR, NEW YORK, NY 10128-4077
(212) 996-8000
(212) 348-1260
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
152726
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
669661
—
NY
Enumeration date
09/29/2006
Last updated
12/10/2010
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