Provider Demographics
NPI:1225297112
Name:RUKMINI S KENIA MD PC
Entity Type:Organization
Organization Name:RUKMINI S KENIA MD PC
Other - Org Name:WESTFIELD PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUKMINI
Authorized Official - Middle Name:S
Authorized Official - Last Name:KENIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-562-8330
Mailing Address - Street 1:65 SPRINGFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085
Mailing Address - Country:US
Mailing Address - Phone:413-562-8330
Mailing Address - Fax:413-562-3430
Practice Address - Street 1:65 SPRINGFIELD ROAD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085
Practice Address - Country:US
Practice Address - Phone:413-562-8330
Practice Address - Fax:413-562-3430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52732208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3085261Medicare PIN