Individual
DR. KENNETH J PIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1565 N MAIN ST, SUITE 306, FALL RIVER, MA 02720-2972
(508) 973-9500
(508) 973-0351
Mailing address
200 MILL ROAD, SUITE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
60524
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110056517A
—
MA
05
—
KP13640
—
RI
Enumeration date
06/01/2005
Last updated
04/23/2020
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