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General NPI Number Information
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NPI Number | 1932137692
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Entity Type | Individual
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Provider Name | JANICE L KENNEDY MD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 165 MILL ST
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City | LEOMINSTER
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State | MA
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Zip | 01453-3242
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Country | US
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Telephone | 978-534-6500
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Fax | 978-534-2991
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Provider Business Mailing Address
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Address Line | 630 PLANTATION ST WOT 12TH FLOOR ATTN PHYSICIAN SERVICES
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City | WORCESTER
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State | MA
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Zip | 01605-2038
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Country | US
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Telephone | 508-368-5529
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Fax | 508-368-5530
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 76277
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License Number State | MA
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