Individual
ELIZABETH JANE KENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2799 ROUTE 112 STE 7&11, MEDFORD, NY 11763-2535
(631) 732-5222
(631) 732-6222
Mailing address
75 TERRACE DR, EAST NORTHPORT, NY 11731-1229
(631) 316-9527
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F383766-01
NY
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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