Individual
DANIEL F KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1945 RTE 33, NEPTUNE, NJ 07753-4859
(732) 776-4420
Mailing address
1945 RTE 33, NEPTUNE, NJ 07753-4859
(732) 776-4420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101015169
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-5-41-0261-5
BCBS PIN
MI
05
—
1881658250
—
MI
Enumeration date
04/13/2006
Last updated
10/20/2011
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