Healthcare Provider Details

I. General information

NPI: 1932387818
Provider Name (Legal Business Name): ROBERT E. KANE OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 NEW MILFORD TURNPIKE
NEW PRESTON CT
06777-1610
US

IV. Provider business mailing address

PO BOX 2443 168 NEW MILFORD TURNPIKE
NEW PRESTON CT
06777-1610
US

V. Phone/Fax

Practice location:
  • Phone: 860-868-2020
  • Fax: 860-868-2787
Mailing address:
  • Phone: 860-868-2020
  • Fax: 860-868-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number000767
License Number StateCT

VIII. Authorized Official

Name: MRS. SANDY J PAPSIN
Title or Position: SECRETARY
Credential:
Phone: 860-868-2020