Eveleine Louise Kennedy, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

238432-1 Issued in NY

Practice address

31 Industrial Blvd
Medford, NY 11763-2220

Phone

(631) 924-4411

Fax

(631) 924-0563

NPI assigned

Mar 30, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Yaphank Center

  • Community/Behavioral Health Agency
  • Medford, NY
  • NPI 1790147411
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1962727289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 INDUSTRIAL BLVD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632220",
            "telephone_number": "631-924-4411",
            "fax_number": "631-924-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 INDUSTRIAL BLVD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632220",
            "telephone_number": "631-924-4411",
            "fax_number": "631-924-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "EVELEINE",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "238432-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jae Kang
• John Karahalis
• Amanda Elizabeth Kearns, MS SLP
• Kelly L Keefe
• Joanna E Kelly, LCSW
• Melisssa Ann Kennedy, BA, MS
• Elizabeth Jane Kenney, PNP
• Kenul Chiropractic PLLC
• Dillon Kenul, DC
• Robert A Kenul, D.C.

• Adult Psychiatric/Mental Health Registered Nurse in Medford, NY
• Providers in Medford, NY by specialty
• Adult Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.