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Individual

DR. KEVIN J REAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
35 KENNEDY DR, PUTNAM, CT 06260-1939
(860) 963-2133
(860) 963-8955
Mailing address
35 KENNEDY DR, PUTNAM, CT 06260-1939
(860) 963-2133
(860) 963-8955

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
036021
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001360213
CT
Enumeration date
06/30/2005
Last updated
05/13/2015
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