Organization
MAUKS KOEPKE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE ROY BBA, MBA (OFFICE MANAGER)
(203) 743-4168
Entity
Organization
Contact information
Practice address
57 NORTH ST, SUITE # 309-310, DANBURY, CT 06810-5660
(203) 794-0761
(203) 731-5399
Mailing address
57 NORTH ST, SUITE # 309-310, DANBURY, CT 06810-5660
(203) 794-0761
(203) 731-5399
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CT
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
CT
207QA0505X
Adult Medicine Physician
—
CT
207R00000X
Internal Medicine Physician
—
CT
208000000X
Pediatrics Physician
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2V4400
HEALTHNET
CT
01
—
3188644
AETNA
CT
01
—
P2879962
OXFORD
CT
Enumeration date
09/21/2005
Last updated
07/21/2022
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