Kennedy, Audrey J

Kennedy, Audrey J is an sole proprietor health care provider with primary practice located at 1533 Memorial Dr , Oakland MD 21550-4338. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Kennedy, Audrey J can be contacted via phone (301) 334-1123.

Contact Information

Primary practice address
1533 Memorial Dr Oakland MD 21550-4338
Phone: (301) 334-1123
Fax: (301) 334-1129
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 18757 Maryland

Profile Details

NPI number 1851490510
LBN Legal business name Kennedy, Audrey J
Credentials PHYSICAL THERAPIST
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2006
Last updated Feb 28th, 2023 - 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 1851490510 NPPES
Maryland Other 54736705 CAREFIRST BCBS
Maryland Other 0003 CAREFIRST BCBS
Maryland Other 4345383 CAREFIRST BCBS
Maryland MEDICAID 0200278000 CAREFIRST BCBS

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