Individual
SHANE P KINSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1260 SILAS DEANE HIGHWAY, WETHERSFIELD, CT 06109
(860) 529-1100
Mailing address
PO BOX 1086, HARTFORD MEDICAL GROUP, WILBRAHAM, MA 01095-1086
(508) 595-0531
(508) 829-5367
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001450
CT
Other
Enumeration date
12/27/2005
Last updated
12/21/2007
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