Individual
DONALD KAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2 BROADWAY STE 2, NORTH HAVEN, CT 06473
(203) 234-6500
(203) 234-6503
Mailing address
2 BROADWAY STE 2, NORTH HAVEN, CT 06473-2370
(203) 234-6500
(203) 234-6503
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
000919
CT
363A00000X
Physician Assistant
Primary
000919
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091900
CONNECTICARE
CT
01
—
290000919CT06
ANTHEM BCBS
CT
01
—
P00441644
RAILROADMEDICARE
CT
Enumeration date
09/23/2005
Last updated
12/06/2018
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