MEDICARE: DR. KEVIN DUFFY JR. MD

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
1	207RC0000X	Cardiovascular Disease Physician	MD422223	PA
2	207RC0000X	Cardiovascular Disease Physician	25MA08662000	NJ

General Provider Information

NPI Number	:	1790907673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN DUFFY JR. MD

Provider Business Mailing Address
First Line	:	3400 CIVIC CENTER BLVD
Second Line	:	EAST PAVILION, 2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4306
Country	:	US
Telephone Number	:	215-615-4949
Fax Number	:	215-615-0829

Provider Business Practice Location Address
First Line	:	3400 CIVIC CENTER BLVD
Second Line	:	EAST PAVILION, 2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4306
Country	:	US
Telephone Number	:	215-615-4949
Fax Number	:	215-615-0829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	02/09/2026

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Directions to “ DR. KEVIN DUFFY JR. MD” Practice Location

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