Keneck, Eileen A

Keneck, Eileen A is an individual health care provider with primary practice located at 840 Harrison Ave Menino 1, Boston MA 02118-2905. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Keneck, Eileen A can be contacted via phone (617) 414-4991.

Contact Information

Primary practice address
840 Harrison Ave Menino 1 Boston MA 02118-2905
Phone: (617) 414-4991
Fax: (617) 414-4999
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 75852 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 75852 Massachusetts

Profile Details

NPI number 1316921711
LBN Legal business name Keneck, Eileen A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Jul 3rd, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316921711 NPPES
Massachusetts MEDICAID 110051833A

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