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Individual

DR. KEVIN MICHAEL KENNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.,D

Contact information

Practice address
2909 GRAND AVE, BALDWIN, NY 11510-4315
(516) 841-5150
Mailing address
2909 GRAND AVE, BALDWIN, NY 11510-4315
(631) 269-5800

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
015632-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015632
NYS LICENSE
NY
Enumeration date
11/10/2006
Last updated
09/26/2014
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