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General NPI Number Information
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NPI Number | 1265765598
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Entity Type | Individual
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Provider Name | COURTNEY E. KENNEDY P.A.
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Gender | Female
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 04/10/2013
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Provider Practice Location Address
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Address Line | 69 SAND PIT RD SUITE 300
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City | DANBURY
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State | CT
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Zip | 06810-4088
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Country | US
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Telephone | 203-748-2551
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Fax | 203-790-6375
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Provider Business Mailing Address
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Address Line | 69 SAND PIT RD SUITE 300
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City | DANBURY
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State | CT
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Zip | 06810-4088
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Country | US
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Telephone | 203-748-2551
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Fax | 203-790-6375
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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