Healthcare Provider Details

I. General information

NPI: 1932401262
Provider Name (Legal Business Name): DAWN M. KENNEDY-LITTLE, DO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W NEW JERSEY AVE
LONG BEACH TOWNSHIP NJ
08008-2764
US

IV. Provider business mailing address

120 W NEW JERSEY AVE
LONG BEACH TOWNSHIP NJ
08008-2764
US

V. Phone/Fax

Practice location:
  • Phone: 609-413-1043
  • Fax: 609-492-4798
Mailing address:
  • Phone: 609-413-1043
  • Fax: 609-324-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MB07337300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MB07337300
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB07337300
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number25MB07337300
License Number StateNJ

VIII. Authorized Official

Name: DR. DAWN M KENNEDY-LITTLE
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 609-413-1043