Individual
MS. CAROLINE F KANE-CIVITANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
105 NEWTOWN RD, SUITE 1A, DANBURY, CT 06810-4194
(203) 790-4511
Mailing address
105 NEWTOWN RD, SUITE 1A, DANBURY, CT 06810-4194
(203) 790-4511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001106
CT
363AM0700X
Medical Physician Assistant
010710
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001106
CT LICENSE
CT
01
—
010710
LICENSE
NY
Enumeration date
08/28/2009
Last updated
03/07/2023
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