Kavanagh, Kenneth C
Kavanagh, Kenneth C is an individual health care provider with primary practice located at 780 Albany St , Boston MA 02118-2524. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Kavanagh, Kenneth C can be contacted via phone (857) 654-1600.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | ARNP9200934 | Florida |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | ARNP9200934 | Florida |
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 213555 | Massachusetts |
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 213555 | Massachusetts |
Profile Details
NPI number | 1699825919 |
---|---|
LBN Legal business name | Kavanagh, Kenneth C |
Credentials | ARNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 11th, 2007 |
Last updated | Dec 12th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1699825919 | NPPES |
Florida | MEDICAID | 305613900 | |
Florida | Other | Y124U |
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