Provider Demographics
NPI:1285734533
Name:KENNA, ROBIN CHRISTI (PA-C)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:CHRISTI
Last Name:KENNA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 RESEARCH PKWY
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1929
Mailing Address - Country:US
Mailing Address - Phone:203-265-9122
Mailing Address - Fax:203-265-9159
Practice Address - Street 1:8 RESEARCH PKWY
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1929
Practice Address - Country:US
Practice Address - Phone:203-265-9122
Practice Address - Fax:203-265-9159
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS53489Medicare UPIN