Healthcare Provider Details

I. General information

NPI: 1326064197
Provider Name (Legal Business Name): ROBERT W KUGLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 FRANKLIN ST
WATERBURY CT
06706-1221
US

IV. Provider business mailing address

56 FRANKLIN ST 3RD FLOOR
WATERBURY CT
06706-1221
US

V. Phone/Fax

Practice location:
  • Phone: 203-709-6004
  • Fax: 203-709-3700
Mailing address:
  • Phone: 203-709-8873
  • Fax: 203-709-8689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number040295
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: