Provider Demographics
NPI:1750434973
Name:BRANCO, KENNETH F
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:F
Last Name:BRANCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 AMERICAN LEGION HWY
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4830
Mailing Address - Country:US
Mailing Address - Phone:508-636-3780
Mailing Address - Fax:508-636-5729
Practice Address - Street 1:216 AMERICAN LEGION HWY
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-4830
Practice Address - Country:US
Practice Address - Phone:508-636-3780
Practice Address - Fax:508-636-5729
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA473171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist