Organization
KENNEDY KRIEGER ASSOCIATES
Active
Parent organization
KENNEDY KRIEGER ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNEDY KRIEGER ASSOCIATES
Authorized official
LISA BADIE (VICE PRESIDENT FINANCE)
(443) 923-1812
Entity
Organization
Contact information
Practice address
11830 W MARKET PL STE NQ, FULTON, MD 20759-2431
(443) 923-9327
Mailing address
PO BOX 45944, BALTIMORE, MD 21297-5944
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168641100
—
MD
01
—
F158
BLUECROSS FEDERAL
MD
01
—
K631
BLUECROSS MARYLAND
MD
Enumeration date
01/03/2025
Last updated
01/03/2025
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