NPI 1972098184

Kenderick Renard Street, IDC

Practitioner Other Technician New Haven, CT

Practice location

Address: 503 Townsend Ave, New Haven, CT 06512-3653
Phone: (912) 331-3110

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Connecticut →

Registry record

NPI: 1972098184
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jun 2018
Record last updated: 29 Jun 2018

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.