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General NPI Number Information
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NPI Number | 1043223597
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Entity Type | Individual
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Provider Name | ALAN DAVID KESTENBAUM M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 64 ROBBINS ST
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City | WATERBURY
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State | CT
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Zip | 06708-2600
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Country | US
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Telephone | 203-573-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CITY PL PH 3103
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City | WHITE PLAINS
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State | NY
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Zip | 10601-3345
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Country | US
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Telephone | 914-720-6325
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 1678921
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 66608
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License Number State | CT
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