Provider Demographics
NPI:1427159003
Name:CORNEA CONSULTANTS - KENNETH R KENYON MD PC
Entity type:Organization
Organization Name:CORNEA CONSULTANTS - KENNETH R KENYON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:KENYON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-496-5063
Mailing Address - Street 1:5 WHITTIER PL STE 102
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-1429
Mailing Address - Country:US
Mailing Address - Phone:617-248-3875
Mailing Address - Fax:
Practice Address - Street 1:5 WHITTIER PL STE 102
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1429
Practice Address - Country:US
Practice Address - Phone:617-248-3875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty