Provider Demographics
NPI:1821251836
Name:CARNEY, CAITLIN KENNEDY (MD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:KENNEDY
Last Name:CARNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ELIZABETH
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:280 MERRIMACK ST STE 311
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1779
Mailing Address - Country:US
Mailing Address - Phone:978-691-5690
Mailing Address - Fax:978-691-5693
Practice Address - Street 1:1 WALLACE BASHAW WAY STE 1002
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3876
Practice Address - Country:US
Practice Address - Phone:978-691-5690
Practice Address - Fax:978-691-5693
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254611207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology