Individual
NAA-DEI KOTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
428 COLUMBUS AVE, INTERNAL MEDICINE, NEW HAVEN, CT 06519-1233
(203) 503-3000
(203) 503-3224
Mailing address
400 COLUMBUS AVE, CREDENTIALING, NEW HAVEN, CT 06519-1233
(203) 503-3000
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
270420
MA
207QA0505X
Adult Medicine Physician
Primary
67335
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008101204
—
CT
Enumeration date
06/24/2014
Last updated
08/10/2021
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