Individual
BETHANY H KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP, MSN, RN
Contact information
Practice address
2171 JERICHO TPKE STE 135, COMMACK, NY 11725-2947
(631) 670-6525
Mailing address
2171 JERICHO TPKE STE 135, COMMACK, NY 11725-2947
(631) 670-6525
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306535
NY
Other
Enumeration date
07/07/2013
Last updated
10/05/2014
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