Individual
DR. LISA BRAZZAMANO KENNEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
44 BINNEY ST, DANA FARBER CANCER INSTITUTE, BOSTON, MA 02115
(617) 632-2292
Mailing address
77 FOX RUN RD, SUDBURY, MA 01776
(918) 443-5729
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
81991
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081991
TUFTS
—
01
—
1888596
CIGNA
—
01
—
3145425
MASS HEALTH (MA MEDICAID)
—
01
—
9358
HPHC (DFCI ONLY)
—
01
—
97496
FALLON COMMUNITY HEALTH P
—
01
—
J16320
BCBS OF MA, INDEMNITY, BC
—
Enumeration date
05/24/2006
Last updated
07/08/2007
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