Provider Demographics
NPI:1649410309
Name:KENNEDY, WILLIAM ALOYSIUS III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALOYSIUS
Last Name:KENNEDY
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:215 MIDDLE NECK RD STE B16-2B
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1170
Mailing Address - Country:US
Mailing Address - Phone:516-313-1027
Mailing Address - Fax:646-657-0347
Practice Address - Street 1:200 MIDDLE NECK RD STE H
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1107
Practice Address - Country:US
Practice Address - Phone:516-313-1027
Practice Address - Fax:646-657-0347
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2021-11-19
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Provider Licenses
StateLicense IDTaxonomies
NY252884207Y00000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology