DR. MARY THERESA KENNEDY (NPI# 1861479636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861479636 |
| Entity Type | Individual |
| Full Name | DR. MARY THERESA KENNEDY |
| Other Name | DR. MARY THERESA REILLY |
| Credential | PHD |
| Practice Address |
217-04 Northern Blvd Ste 16 Bayside NY 11361-3500 |
| Mailing Address |
218-11 Horace Harding Blvd Bayside NY 11364-2211 |
| Practice Telephone | 7186318939 |
| Mailing Telephone | 7186318939 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2010-09-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
00760201 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01067481 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336418169 | Mary Katherine Kennedy | Developmental Therapist | 10727 Burr Oak Way, Burke, VA 22015-2414 | 2011-12-22 |
| 1568635738 | Mary A Kennedy | Speech-Language Pathologist | 1801 Alfresco Pl, Louisville, KY 40205-1807 | 2008-04-09 |
| 1518095660 | Mary S. Kennedy | Social Worker | 16 Fayette St, Cambridge, MA 02139-1112 | 2007-03-01 |
| 1053455568 | Mary Kathleen Kennedy | Speech-Language Pathologist | 1613 Ginger Dr, Hideaway, TX 75771-5311 | 2007-02-16 |
| 1578656716 | Mary Kennedy | Nurse Practitioner | 105 E Hack St, Cullom, IL 60929 | 2006-10-02 |
| 1093821894 | Mary Kathryn Kennedy | Nurse Anesthetist, Certified Registered | 1845 S Fm 51 Unit A-2, Decatur, TX 76234-3764 | 2006-08-22 |
| 1992750517 | Mary Kay Kennedy | Social Worker | 363 South Harlan Street, Suite 200, Denver, CO 80226-3552 | 2006-05-23 |
| 1972563757 | Mary M Kennedy | Social Worker | 181 W Professional Park Ct, Suite 1, Bowling Green, KY 42104-3250 | 2006-03-24 |
| 1518471226 | Mary Kennedy | Counselor | 1010 Remington Plz, Raymore, MO 64083-8640 | 2017-11-17 |
| 1871851196 | Mary Kennedy | Day Training/Habilitation Specialist | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2012-04-24 |
| Street Address |
217-04 NORTHERN BLVD STE 16 |
| City | BAYSIDE |
| State | NY |
| Zip Code | 11361-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467078055 | Nicole E. Sarracco | Speech-Language Pathologist | 215 - 46 39th Avenue, Flushing, NY 11361 | 2020-06-19 |
| 1689294381 | Terri Robin Will | Registered Nurse | 3416 2019th Street, Queens, NY 11361 | 2020-04-22 |
| 1295364875 | Melanie Besthoff | Speech-Language Pathologist | 215-46 39th Avenue, Flushing, NY 11361 | 2020-04-05 |
| 1790339844 | Alana Valle | Occupational Therapist | 20947 34th Rd, Bayside, NY 11361 | 2019-07-26 |
| 1881175826 | Eva Mui | Pharmacist | 212 Northern Blvd, Bayside, NY 11361 | 2018-08-28 |
| 1063908531 | Hongik Acupuncture N.y. P.C. | Acupuncturist | 21441 42nd Ave Ste 4c, Bayside, NY 11361 | 2018-07-07 |
| 1093233694 | Karen Trentacosta | Registered Nurse | 40-04a Bell Boulevard, Bayside, NY 11361 | 2017-09-03 |
| 1801310131 | Hee Gi An | Dentist | 42-05 204th St, Flr 2, Bayside, NY 11361 | 2017-07-28 |
| 1780113050 | Miaoying Zhu | Social Worker | 217-63 Corbett Rd, Bayside, NY 11361 | 2017-06-08 |
| 1679016265 | Daniela Ragusa | Speech-Language Pathologist | 221-21 Corbett Road, Bayside, NY 11361 | 2016-11-30 |
| Find all providers in zip 11361 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619520608 | Georgios Mavrolefteros | Psychologist | 4311 211th St, Bayside, NY 11361-2836 | 2019-07-19 |
| 1003322082 | Christine Marie Bartholoma | Psychologist | 1327 Bell Blvd, Bayside, NY 11360-1204 | 2017-12-28 |
| 1912364373 | Tiffany Ann Avon | Psychologist | 207-28 Jordan Drice, Bayside, NY 11360 | 2016-01-15 |
| 1346319100 | Irwin Feldinger | Psychologist | 214 06 16th Ave, Bayside, NY 11360-1218 | 2006-11-07 |
| 1326133547 | Lynn F Birnbaum | Psychologist | 23 50 Waters Edge Drive, #3e, Bayside, NY 11360-2204 | 2006-10-04 |
| 1659464634 | Angelo R Caredo | Psychologist | 38-11 Corporal Stone Street, Bayside, NY 11361-2140 | 2006-10-02 |
| 1548369663 | Nicholas Gavalas | Psychologist | 21015 Union Turnpike, Bayside, NY 11364 | 2006-09-22 |
| 1124015425 | Linda Sherry Berman | Psychologist | 21245 26th Ave, Suite 8a, Bayside, NY 11360-1901 | 2005-10-01 |
| 1477965978 | New York Psychological Wellness, PC | Psychologist | 4640 Springfield Blvd, Bayside, NY 11361-3517 | 2014-06-02 |
| 1568632784 | Leeanne Homburger Bonnet | Psychologist | 2901 216th St, Bayside, NY 11360-2810 | 2008-03-04 |
| Find all providers in BAYSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.