Healthcare Provider Details

I. General information

NPI: 1467515452
Provider Name (Legal Business Name): SAMIR H KAILANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 WATER ST
MILFORD MA
01757-3036
US

IV. Provider business mailing address

9 INDUSTRIAL RD STE 5
MILFORD MA
01757-3736
US

V. Phone/Fax

Practice location:
  • Phone: 508-478-4500
  • Fax: 508-478-5235
Mailing address:
  • Phone: 508-473-1480
  • Fax: 508-473-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberL1243
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number239050
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: