1649270018 NPI number — DR. WILLIAM FRANCIS KENNY M.D., FAPA

Table of content: DR. WILLIAM FRANCIS KENNY M.D., FAPA (NPI 1649270018)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649270018 NPI number — DR. WILLIAM FRANCIS KENNY M.D., FAPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KENNY
Provider First Name:
WILLIAM
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., FAPA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649270018
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 KENSINGTON AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINGSTON
Provider Business Mailing Address State Name:
ONTARIO
Provider Business Mailing Address Postal Code:
K7L4B4
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
613-544-8068
Provider Business Mailing Address Fax Number:
613-544-8623

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7550 S STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOWVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13367-1533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-376-5450
Provider Business Practice Location Address Fax Number:
315-376-7221
Provider Enumeration Date:
07/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  087795-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00657649 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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