Individual
KEVIN PATRICK GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 MAIN ST, BUILDING 4, PLANTSVILLE, CT 06479-1565
(860) 378-2891
(860) 378-2894
Mailing address
710 MAIN ST, BUILDING 4, PLANTSVILLE, CT 06479-1565
(860) 378-2891
(860) 378-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036278
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001362780
—
CT
Enumeration date
02/27/2006
Last updated
03/21/2013
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