Dr. Gregory Thomas Kennedy
Student in an Organized Health Care Education/Training Program in Stanford, CA. Individual provider (NPI-1).
NPI number1124550009
StatusActive
Last updated in NPPESJun 21, 2024
Details
- NPI
- 1124550009
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gregory Thomas Kennedy
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 30, 2017
- Certification date
- Jun 21, 2024
- Last updated
- Jun 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
300 Pasteur DrStanford, CA 94305-2200
Phone 215-410-9829
Mailing address
700 Clark Way Unit 27-1070Palo Alto, CA 94304-2398
Phone 215-410-9829
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