Provider Demographics
NPI:1861448672
Name:KENNEY, RICHARD J (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:KENNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:80 LANDINGS DRIVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9408
Mailing Address - Country:US
Mailing Address - Phone:724-941-3020
Mailing Address - Fax:724-941-7788
Practice Address - Street 1:80 LANDINGS DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9408
Practice Address - Country:US
Practice Address - Phone:724-941-3020
Practice Address - Fax:724-941-7788
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009283L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA108119OtherBLUE CROSS
PA6800690002Medicaid
H41681Medicare UPIN