Healthcare Provider Details

I. General information

NPI: 1922131309
Provider Name (Legal Business Name): PATRICIA JEAN KENDALL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 MOSCOW RD
HAMLIN NY
14464-9729
US

IV. Provider business mailing address

629 MOSCOW RD # 278980
HAMLIN NY
14464-9729
US

V. Phone/Fax

Practice location:
  • Phone: 585-797-8069
  • Fax: 201-547-1965
Mailing address:
  • Phone: 585-797-8069
  • Fax: 585-637-5626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334642-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: