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 |
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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 |
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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 |
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Provider Enumeration Date | 06/07/2024 |
Last Update Date | 12/27/2024 |
Medicare PECOS PAC ID | 1850834169 |
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Medicare Enrollment ID | O20240614002258 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447092853 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Cort Chedwin Kennedy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730719659 PECOS PAC ID: 2567817570 Enrollment ID: I20231011002713 |
Alfonso Tan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 297 W Main St, Sayville, NY 11782 Phone: 631-589-2323 Fax: 631-589-9069 | |
Philip Degaetano D.o.p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 Sayville Blvd, Sayville, NY 11782 Phone: 631-806-1357 |