Provider Demographics
NPI:1184845968
Name:KINNEY, GENEVIEVE AGNES (DMD)
Entity Type:Individual
Prefix:DR
First Name:GENEVIEVE
Middle Name:AGNES
Last Name:KINNEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 W 56TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3831
Mailing Address - Country:US
Mailing Address - Phone:212-977-6046
Mailing Address - Fax:212-977-9615
Practice Address - Street 1:162 W 56TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3831
Practice Address - Country:US
Practice Address - Phone:212-977-6046
Practice Address - Fax:212-977-9615
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0413621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice