Organization
RESILIENT LIVING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE M KENNY MD (PHYSICIAN)
(860) 628-9000
Entity
Organization
Contact information
Practice address
1261 S MAIN ST, PLANTSVILLE, CT 06479-1750
(860) 628-9000
Mailing address
1261 S MAIN ST, PLANTSVILLE, CT 06479-1750
(860) 628-9000
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
030589
CT
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
030589
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043293780
—
CT
Enumeration date
02/13/2017
Last updated
02/13/2017
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