Healthcare Provider Details

I. General information

NPI: 1952988685
Provider Name (Legal Business Name): NISRINE KAWA MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ROBBINS ST
WATERBURY CT
06708-2652
US

IV. Provider business mailing address

64 ROBBINS ST
WATERBURY CT
06708-2613
US

V. Phone/Fax

Practice location:
  • Phone: 203-573-7284
  • Fax:
Mailing address:
  • Phone: 203-573-6162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number334292
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: