Kennedy, Michael

Kennedy, Michael is an sole proprietor health care provider with primary practice located at 17 Southdown Rd , Huntington NY 11743-2538. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Kennedy, Michael can be contacted via phone (631) 923-2139.

Contact Information

Primary practice address
17 Southdown Rd Huntington NY 11743-2538
Phone: (631) 923-2139
Fax: (631) 923-2140
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 171806 New York
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X OS-006765-E Pennsylvania
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 02524 North Carolina
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 20A18353 California
Allopathic & Osteopathic Physicians / Sports Medicine 207PS0010X 420 South Carolina

Profile Details

NPI number 1982778486
LBN Legal business name Kennedy, Michael
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 17th, 2006
Last updated Mar 15th, 2022 - about 2 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 1982778486 NPPES
New York MEDICAID 01071058

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