Healthcare Provider Details

I. General information

NPI: 1275733651
Provider Name (Legal Business Name): AMY KAPPELMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY KAPPELMAN JOHNSON M.D.

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 W END AVE GREENWICH PEDIATRIC ASSOCIATES
OLD GREENWICH CT
06870-1642
US

IV. Provider business mailing address

8 W END AVE C/O GREENWICH PEDIATRIC ASSOCIATES
OLD GREENWICH CT
06870-1642
US

V. Phone/Fax

Practice location:
  • Phone: 203-637-3212
  • Fax: 203-637-3172
Mailing address:
  • Phone: 203-637-3212
  • Fax: 203-637-3172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number045627
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: