Healthcare Provider Details

I. General information

NPI: 1598216921
Provider Name (Legal Business Name): S. LOWELL KAHN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 ASHLEY AVE
WEST SPRINGFIELD MA
01089-1302
US

IV. Provider business mailing address

86 ASHLEY AVE
WEST SPRINGFIELD MA
01089-1302
US

V. Phone/Fax

Practice location:
  • Phone: 413-693-2852
  • Fax: 413-693-2854
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SIDNEY LOWELL KAHN IV
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential: MD
Phone: 413-429-6668