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General NPI Number Information
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NPI Number | 1225185051
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Entity Type | Individual
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Provider Name | KATHLEEN M KENNEY-RILEY RNP
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 111 E 210TH ST MMC - PEDIATRIC ER
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City | BRONX
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State | NY
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Zip | 10467-2401
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Country | US
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Telephone | 718-741-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 1 LANDMARK SQ APT # 613
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City | PORT CHESTER
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State | NY
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Zip | 10573-3348
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Country | US
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Telephone | 718-741-2150
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Fax | 718-741-2237
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 380370
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 12.008134
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License Number State | CT
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