Healthcare Provider Details

I. General information

NPI: 1134162761
Provider Name (Legal Business Name): DENISE MARIE KEARNEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 PLEASANT ST
NORTHAMPTON MA
01060-3914
US

IV. Provider business mailing address

106 NOROTON AVE
DARIEN CT
06820-5237
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-7787
  • Fax: 413-584-7778
Mailing address:
  • Phone: 203-655-9904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number044300
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: