MS. EVELEINE LOUISE KENNEDY (NPI# 1962727289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962727289 |
| Entity Type | Individual |
| Full Name | MS. EVELEINE LOUISE KENNEDY |
| Credential | RN |
| Practice Address |
31 Industrial Blvd Medford NY 11763-2220 |
| Practice Telephone | 6319244411 |
| Practice Fax Number | 6319240563 |
| Mailing Telephone | 6319244411 |
| Mailing Fax Number | 6319240563 |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2010-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
238432-1 | NY | Nursing Service Providers |
| Street Address |
31 INDUSTRIAL BLVD |
| City | MEDFORD |
| State | NY |
| Zip Code | 11763-2220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265646087 | Tracy A. Cullen | Social Worker | 31 Industrial Blvd, Medford, NY 11763-2220 | 2007-05-10 |
| 1992326375 | Kerry Anderson | Social Worker | 31 Industrial Blvd, Medford, NY 11763-2220 | 2020-04-27 |
| 1609316504 | Darlene Lewis | Social Worker | 31 Industrial Blvd, Medford, NY 11763-2220 | 2017-02-27 |
| 1760922652 | Michelle Muller | Peer Specialist | 31 Industrial Blvd, Medford, NY 11763-2220 | 2017-02-27 |
| 1962859488 | Mcreynald Balthazar | Registered Nurse | 31 Industrial Blvd, Medford, NY 11763-2220 | 2016-05-16 |
| 1912369224 | Gail Rudy-giannino | Counselor | 31 Industrial Blvd, Medford, NY 11763-2220 | 2016-03-25 |
| 1952763716 | Kathleen Lao | Counselor | 31 Industrial Blvd, Medford, NY 11763-2220 | 2016-03-22 |
| 1790147411 | The Yaphank Center | Community/Behavioral Health | 31 Industrial Blvd, Medford, NY 11763-2220 | 2016-03-22 |
| 1770945552 | Marilyn Clarke | Peer Specialist | 31 Industrial Blvd, Medford, NY 11763-2220 | 2016-03-22 |
| 1447612171 | Thomas Gaynor | Rehabilitation Practitioner | 31 Industrial Blvd, Medford, NY 11763-2220 | 2016-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1265917041 | Bay Taxi Inc | Taxi | 36/94 Horseblock Rd, Medford, NY 11763 | 2018-09-27 |
| 1184108383 | Bay Taxi Inc | Taxi | 36/94 Horsblock Road, Medford, NY 11763 | 2018-09-24 |
| 1215419650 | Megan Bell | Speech-Language Pathologist | 135 Buffalo Avenue, Medford, NY 11763 | 2018-09-01 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1609383389 | Federation of Organizations for The New York State Mentally Disabled | Clinic/Center | 3390 Route 112 Ste B, Medford, NY 11763 | 2018-01-04 |
| 1497109607 | Tabitha Aitken | Massage Therapist | 28 Masem Ct, Medford, NY 11763 | 2016-04-14 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1134527054 | Angelo L D'esposito | Social Worker | 77 Robinson Ave, Medford, NY 11763 | 2014-12-09 |
| Find all providers in zip 11763 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861578353 | Jan Scott Garlock | Registered Nurse | 3140 Juanipero Way, Suite 102, Medford, OR 97504-8640 | 2006-10-27 |
| 1144545468 | Janice Gallagher | Registered Nurse | 31 Industrial Blvd, Medford, NY 11763-2220 | 2010-03-30 |
| 1750521563 | Hyman Samuel Beshansky | Registered Nurse | 170 Governors Ave, Medford, MA 02155-1643 | 2009-03-06 |
| 1811137086 | Addie Clare Dublin | Registered Nurse | 26 City Hall Mall, Medford, MA 02155-4754 | 2009-03-02 |
| 1093928806 | Susan Fay Mahoney | Registered Nurse | 124 Professors Row, Tufts University Health Service, Medford, MA 02155-5816 | 2007-05-08 |
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| 1649819616 | Medardo Ocasiones Ebol Jr. | Registered Nurse | Kirby Forensic Psychiatric Center, Wards Island Complex, Manhattan, NY 10035-6095 | 2019-12-23 |
| 1346884376 | Diane Aleksandrowicz | Registered Nurse | 2186 Bear Creek Dr, Ontario, NY 14519-9766 | 2019-11-02 |
| 1104468347 | King Xia | Registered Nurse | 1653 Hubbell St, Bronx, NY 10461-2905 | 2019-10-09 |
| 1699316497 | Zoey Luan | Registered Nurse | 89 Metropolitan Oval Apt 1e, Bronx, NY 10462-6411 | 2019-10-02 |
| 1699325993 | Michelle Yvonne Cerutti | Registered Nurse | 33 Mitchell Ave Ste G-80, Binghamton, NY 13903-1642 | 2019-09-18 |
| 1235792672 | Ann Marie Pignatti | Registered Nurse | 8093 Ashery Ln, Cicero, NY 13039-8353 | 2019-04-22 |
| 1619438785 | Debra Rieben | Registered Nurse | 711a Old Lane Rd, Vestal, NY 13850-3570 | 2019-03-29 |
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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.