Provider Demographics
NPI:1265461925
Name:KILKENNY-TRAINOR, KERRYANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KERRYANN
Middle Name:
Last Name:KILKENNY-TRAINOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1689
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07962-1689
Mailing Address - Country:US
Mailing Address - Phone:973-538-8837
Mailing Address - Fax:973-538-3650
Practice Address - Street 1:11 HILL ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5328
Practice Address - Country:US
Practice Address - Phone:973-538-5844
Practice Address - Fax:973-267-0181
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA60493207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6915400Medicaid
NJF86422Medicare UPIN
NJ115164MNGMedicare ID - Type Unspecified