Individual
KEVIN PETER MCGRATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
912 SILAS DEANE HWY STE 100, WETHERSFIELD, CT 06109-3497
(860) 257-3535
(860) 257-0551
Mailing address
912 SILAS DEANE HWY, STE 100, WETHERSFIELD, CT 06109-3434
(203) 255-9155
(860) 257-0551
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
027965
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010027965CT01
BCBS
CT
01
—
0V0206
HEALTHNET/ACS
CT
Enumeration date
06/08/2005
Last updated
07/01/2021
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