Individual
MR. KENDERICK RENARD STREET JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
503 TOWNSEND AVE, NEW HAVEN, CT 06512-3653
(912) 331-3110
Mailing address
503 TOWNSEND AVE, NEW HAVEN, CT 06512-3653
(912) 331-3110
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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