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NPI Code Detail

MEDICARE: DEAN KENNEY P.A.

MEDICARE: DEAN KENNEY P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant005056NY

General Provider Information

NPI Number : 1568506558
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEAN KENNEY P.A.
Provider Business Mailing Address
First Line : 3 CALIFORNIA PL S
Second Line :
City : ISLAND PARK
State : NY
Zip : 11558-2216
Country : US
Telephone Number : 516-431-0698
Fax Number :
Provider Business Practice Location Address
First Line : 1011 W BEECH ST
Second Line :
City : LONG BEACH
State : NY
Zip : 11561-1203
Country : US
Telephone Number : 516-431-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 12/09/2014

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Directions to “ DEAN KENNEY P.A.” Practice Location

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