MEDICARE: RUCHI KAPOOR PA

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	363AM0700X	Medical Physician Assistant	011345	NY
2	363AM0700X	Medical Physician Assistant	5196	CT

General Provider Information

NPI Number	:	1780617928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUCHI KAPOOR PA

Provider Business Mailing Address
First Line	:	1817 BLACK ROCK TPKE STE 206
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825-3546
Country	:	US
Telephone Number	:	203-337-5333
Fax Number	:	203-337-5360

Provider Business Practice Location Address
First Line	:	1817 BLACK ROCK TPKE STE 206
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825-3546
Country	:	US
Telephone Number	:	203-337-5333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	11/05/2024

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Directions to “ RUCHI KAPOOR PA” Practice Location

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