Healthcare Provider Details

I. General information

NPI: 1972646560
Provider Name (Legal Business Name): ALAN P KENNY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 01/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVENUE ML 7009
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVENUE ML 7009
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4830
  • Fax: 513-636-7868
Mailing address:
  • Phone: 513-636-4830
  • Fax: 513-636-7868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35.088255
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: