Healthcare Provider Details

I. General information

NPI: 1730050394
Provider Name (Legal Business Name): JOSEPH LOUIS KAPLOWE III PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 LEWIS AVE STE 103
MERIDEN CT
06451-2121
US

IV. Provider business mailing address

1290 SILAS DEANE HWY HHC-CVO
WETHERSFIELD CT
06109-4337
US

V. Phone/Fax

Practice location:
  • Phone: 203-694-7550
  • Fax: 203-239-1026
Mailing address:
  • Phone: 203-694-7550
  • Fax: 203-239-1026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number23.007322
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number23.007322
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number23.007322
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: