Provider Demographics
NPI:1528006467
Name:KENNA, GEORGE ANTHONY (PHD, RPH)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ANTHONY
Last Name:KENNA
Suffix:
Gender:M
Credentials:PHD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BEDFORD LN
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-7008
Mailing Address - Country:US
Mailing Address - Phone:401-294-4730
Mailing Address - Fax:401-456-6762
Practice Address - Street 1:59 BEDFORD LN
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-7008
Practice Address - Country:US
Practice Address - Phone:401-294-4730
Practice Address - Fax:401-456-6762
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI26441835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric