Individual
PETER J KENNELTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.T.A.
Contact information
Practice address
61 GARDNER AVE, MIDDLETOWN, NY 10940-3211
(914) 443-6505
Mailing address
61 GARDNER AVE, MIDDLETOWN, NY 10940-3211
(914) 443-6505
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003632-1
NY
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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