Provider Demographics
NPI:1255942017
Name:KENDT, MARY (CNM)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:KENDT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 PRESIDENTIAL PLAZA
Mailing Address - Street 2:1ST FL
Mailing Address - City:CYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3064
Mailing Address - Country:US
Mailing Address - Phone:315-464-5210
Mailing Address - Fax:315-464-2141
Practice Address - Street 1:90 PRESIDENTIAL PLAZA
Practice Address - Street 2:1ST FL
Practice Address - City:CYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3064
Practice Address - Country:US
Practice Address - Phone:315-464-5210
Practice Address - Fax:315-464-2141
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY795713163W00000X
NY002322176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse