Healthcare Provider Details

I. General information

NPI: 1548216153
Provider Name (Legal Business Name): EDWARD J KUDEJ D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EDWARD J KUDEJ P.T.

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 BOSTON POST RD
MILFORD CT
06460-2635
US

IV. Provider business mailing address

555 BOSTON POST RD
MILFORD CT
06460-2635
US

V. Phone/Fax

Practice location:
  • Phone: 203-878-8803
  • Fax: 203-874-3945
Mailing address:
  • Phone: 203-878-8803
  • Fax: 203-874-3945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number00764
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number002136
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: