Individual
LEAH M. KENNEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
776 LONGMEADOW ST, LONGMEADOW, MA 01106-2219
(413) 565-4400
(413) 565-4411
Mailing address
59 CLEMENT ST, SPRINGFIELD, MA 01118-1511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
941
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
094100
CONNECTICARE PROVIDER NU
MA
01
—
941
LICENSE
MA
Enumeration date
06/05/2006
Last updated
07/08/2007
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