Provider Demographics
NPI:1467157586
Name:KENNEDY, KIERSTEN ROSE (MD)
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:ROSE
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:ALBANY MEDICAL CENTER DEPT. OF MED-PEDS, MAIL CODE 130
Mailing Address - Street 2:1019 NEW LOUDON ROAD
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ALBANY MEDICAL CENTER DEPT. OF MED-PEDS, MAIL CODE 130
Practice Address - Street 2:1019 NEW LOUDON ROAD
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047
Practice Address - Country:US
Practice Address - Phone:518-262-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program