Provider Demographics
NPI:1407043698
Name:DUVAL-KENNEDY, LISA A (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:DUVAL-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 1:59 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-9679
Mailing Address - Country:US
Mailing Address - Phone:413-527-3576
Mailing Address - Fax:
Practice Address - Street 1:59 MAIN RD
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-9679
Practice Address - Country:US
Practice Address - Phone:413-527-3576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55508207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology