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Individual

ELIZABETH KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
404 POTTER BLVD, BRIGHTWATERS, NY 11718-1830
(631) 376-0055
Mailing address
23 ROOSEVELT DR, BETHPAGE, NY 11714-5537

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
12/21/2015
Last updated
12/10/2019
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