NPI 1790629954

Collin Kennedy

Practitioner Independent Duty Corpsman Staten Island, NY

Practice location

Address: 212 Coast Guard Dr, Staten Island, NY 10305-5005
Phone: (718) 354-4353

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1790629954
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Apr 2026
Record last updated: 17 Apr 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.