Basic Information
| Provider Information | |||||||||
| NPI: | 1295153328 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KENNEDY | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3609 FORBES AVE STE 2 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126924888 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3459 FIFTH AVE. | ||||||||
| Address2: | UPMC MONTEFIORE, 9 SOUTH | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127377871 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2014 | ||||||||
| LastUpdateDate: | 03/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD460142 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.