Kennedy, Paul Vincent

Kennedy, Paul Vincent is an sole proprietor health care provider with primary practice located at 117 Watchung Ave 2Nd Floor, Montclair NJ 07043-1710. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Kennedy, Paul Vincent can be contacted via phone (973) 783-2984.

Contact Information

Primary practice address
117 Watchung Ave 2Nd Floor Montclair NJ 07043-1710
Phone: (973) 783-2984
Fax: (973) 783-5074
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 38919 New Jersey
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 38919 New Jersey

Profile Details

NPI number 1194763904
LBN Legal business name Kennedy, Paul Vincent
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 3rd, 2006
Last updated Aug 19th, 2010 - about 16 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 1194763904 NPPES
New Jersey Other P00836064 RR MEDICARE
New Jersey MEDICAID 0224804 RR MEDICARE

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