MEDICARE: S. LOWELL KAHN MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1598216921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S. LOWELL KAHN MD PC

Provider Business Mailing Address
First Line	:	86 ASHLEY AVE
Second Line	:
City	:	WEST SPRINGFIELD
State	:	MA
Zip	:	01089-1302
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	86 ASHLEY AVE
Second Line	:
City	:	WEST SPRINGFIELD
State	:	MA
Zip	:	01089-1302
Country	:	US
Telephone Number	:	413-693-2852
Fax Number	:	413-693-2854

Authorized Official
Title or Position	:	OWNER/AUTHORIZED OFFICIAL
Name	:	DR. SIDNEY LOWELL KAHN IV
Credential	:	MD
Telephone Number	:	413-429-6668

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	03/13/2017

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