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General NPI Number Information
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NPI Number | 1649399171
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Entity Type | Individual
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Provider Name | KEVIN HENNESSY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1601 CHERRY ST SUITE 1700
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1321
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Country | US
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Telephone | 215-282-1736
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Fax |
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Provider Business Mailing Address
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Address Line | 418 FITZWATER ST UNIT B
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City | PHILADELPHIA
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State | PA
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Zip | 19147-3109
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Country | US
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Telephone | 215-282-1736
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP437983
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0000020980
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License Number State | TN
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