Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 70385 | MA |
NPI | 1063450369 |
---|---|
Provider Name | Jeffrey S Kennedy |
First Address | Albany, NY 12208-3412 |
Second Address | Albany, NY 12208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 06/05/2013 |