| Doctor Name: | DR. RYAN KENNY |
| NPI Number: | 1194139469 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 281229-1 |
| Business Practice Address: | 602 Ivy St Elmira, NY - 149051646 |
| Business Phone Number: | 6077378157 |
| Business Fax Number: | 6072713664 |
| Mailing Address: | 602 Ivy St, ELMIRA |
| State: | NY |
| Postal Code: | 149051646 |
| Phone Number: | 6077378157 |
| Fax Number: | 6072713664 |
| NPI Enumeration Date: | 06/16/2014 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 281229-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |