Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 0 | NY |
NPI | 1003487869 |
---|---|
Provider Name | Dr. Frank Bernard Kennedy |
First Address | Newburgh, NY 12550-2952 |
Second Address | Wappingers Falls, NY 12590-7004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2021 |
Last Update Date | 03/08/2021 |