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Individual

JEFFREY MARK KAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
365 WILLARD AVE, SUITE 2-D, NEWINGTON, CT 06111-2373
(860) 665-1571
(860) 667-3668
Mailing address
365 WILLARD AVE, SUITE 2-D, NEWINGTON, CT 06111-2373
(860) 665-1571
(860) 667-3668

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
030937
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001309378
CT
Enumeration date
01/23/2006
Last updated
07/08/2007
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