Mr. Kenderick Renard Street Jr., IDC
Mr. Kenderick Renard Street Jr., IDC is a Military Health Care Provider in Groton, Connecticut. Licensed in Connecticut. Registered with an NPI since 2018.
- Licensed in
- CT
- In the registry since
- 2018
- Specialties on file
- 3
Practice location Address checks out
1 Wahoo Ave Bldg 449Groton, CT 06349-2324
Phone: (860) 694-4123
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Duty Corpsman (primary) | Taxonomy 1710I1002X · Licence 1972098184 (CT) |
|---|---|
| Military Health Care Provider | Taxonomy 171000000X · Licence 1972098184 (CT) |
| Other Technician | Taxonomy 247200000X |
Record details
| NPI number | 1972098184 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | IDC |
| Sole proprietor | No |
| NPI enumerated | June 29, 2018 |
| Last updated in NPPES | September 8, 2026 |
| Certification date | September 8, 2026 |
Other providers in Groton
-
Dr. Mark Michael Morton, DO
1 Wahoo Ave Bldg 449, Groton, CT 06349-2324 · (860) 694-4873
-
Michael Noel Alonzo Peralta
1 Wahoo Ave, Groton, CT 06349-2324 · (860) 581-0090
-
Thomas Rogers
PO Box 159, Groton, CT 06349-5159 · (860) 694-2876
-
Paul B. Schiowitz, IDC
1 Wahoo Ave, Groton, CT 06340-2324 · (860) 694-7511
-
Terell Willard
1 Wahoo Ave, Groton, CT 06349-2324 · (860) 694-3743
-
Meghan Elizabeth Wolf, HEALTHSERVICESTECH
15 Mohegan Rd, Groton, CT 06340-5504 · (860) 444-8435