| Kennedy Krieger Associates | |
|
11830 W Market Pl Ste Nq Fulton MD 20759-2431 | |
| (443) 923-9327 | |
| Not Available |
| Full Name | Kennedy Krieger Associates |
|---|---|
| Speciality | Pediatrics |
| Location | 11830 W Market Pl Ste Nq, Fulton, Maryland |
| Authorized Official Name and Position | Lisa Badie (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 4439231812 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Krieger Associates Po Box 45944 Baltimore MD 21297-5944 Ph: () - | Kennedy Krieger Associates 11830 W Market Pl Ste Nq Fulton MD 20759-2431 Ph: (443) 923-9327 |
| NPI Number | 1962211953 |
|---|---|
| Provider Enumeration Date | 01/03/2025 |
| Last Update Date | 01/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962211953 | NPI | - | NPPES |
| 168641100 | Medicaid | MD | |
| K631 | Other | MD | BLUECROSS MARYLAND |
| F158 | Other | MD | BLUECROSS FEDERAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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