Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 18928715 | PA |
NPI | 1841331915 |
---|---|
Provider Name | Connie J Kennedy |
First Address | Horsham, PA 19044-2607 |
Second Address | Horsham, PA 19044-2607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 08/07/2007 |