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General NPI Number Information
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NPI Number | 1225580038
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Entity Type | Individual
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Provider Name | UCHENNA KATHARINA KENNEDY M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC SURGERY
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 267-226-2896
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 JOHN F KENNEDY BLVD APT 622
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City | PHILADELPHIA
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State | PA
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Zip | 19103-1731
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Country | US
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Telephone | 267-226-2896
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Fax |
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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 | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | LT000762
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License Number State | PA
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