| Cort Chedwin Kennedy Md Pllc | |
|
229 Railroad Ave Ste 3 Sayville NY 11782-2719 | |
| (631) 507-2979 | |
| Not Available |
| Full Name | Cort Chedwin Kennedy Md Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 229 Railroad Ave Ste 3, Sayville, New York |
| Authorized Official Name and Position | Cort Chedwin Kennedy (OWNER) |
| Authorized Official Contact | 6315072979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cort Chedwin Kennedy Md Pllc 364 Vanderbilt Blvd Oakdale NY 11769-2038 Ph: () - | Cort Chedwin Kennedy Md Pllc 229 Railroad Ave Ste 3 Sayville NY 11782-2719 Ph: (631) 507-2979 |
| NPI Number | 1447092853 |
|---|---|
| Provider Enumeration Date | 06/07/2024 |
| Last Update Date | 12/27/2024 |
| Medicare PECOS PAC ID | 1850834169 |
|---|---|
| Medicare Enrollment ID | O20240614002258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447092853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Cort Chedwin Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730719659 PECOS PAC ID: 2567817570 Enrollment ID: I20231011002713 |
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