Provider Demographics
NPI:1295726917
Name:BARBARA A. KILKENNY, DPM
Entity type:Organization
Organization Name:BARBARA A. KILKENNY, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KILKENNY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:203-264-0800
Mailing Address - Street 1:2 POMPERAUG OFFICE PARK
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-2288
Mailing Address - Country:US
Mailing Address - Phone:203-264-0800
Mailing Address - Fax:
Practice Address - Street 1:2 POMPERAUG OFFICE PARK
Practice Address - Street 2:SUITE 106
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-2288
Practice Address - Country:US
Practice Address - Phone:203-264-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000528213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODC0856OtherRAILROAD MEDICARE
CO004250106OtherCONNECTICUT MEDICAL ASSIS
CT004100450Medicaid
CTC03189Medicare PIN
CT480000564Medicare PIN