Provider Demographics
NPI:1306842844
Name:KENNEDY, MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:KENNEDY
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:HEMATOLOGY ONCOLOGY BEAUMONT AVE
Mailing Address - Street 2:GIVEN BUILDING E-14
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05405-2156
Mailing Address - Country:US
Mailing Address - Phone:802-656-5487
Mailing Address - Fax:802-656-5493
Practice Address - Street 1:HEMATOLOGY ONCOLOGY 89 BEAUMONT AVE
Practice Address - Street 2:GIVEN BUILDING E-14
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05405-2156
Practice Address - Country:US
Practice Address - Phone:802-656-5487
Practice Address - Fax:802-656-5493
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422533207RH0003X
VT042-0010571207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008288030001Medicaid
H96353Medicare UPIN
PAKE074203Medicare PIN