Healthcare Provider Details

I. General information

NPI: 1003123548
Provider Name (Legal Business Name): ROOPKIRANJOT KAHLON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 HARTFORD TPKE STE 210
VERNON CT
06066-4759
US

IV. Provider business mailing address

281 HARTFORD TPKE STE 210
VERNON CT
06066-4759
US

V. Phone/Fax

Practice location:
  • Phone: 860-872-8563
  • Fax: 860-870-4857
Mailing address:
  • Phone: 860-872-8563
  • Fax: 860-870-4857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301096752
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number053944
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: