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General NPI Number Information
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NPI Number | 1467759753
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Entity Type | Organization
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Legal Business Name | CHESHIRE ENDOCRINOLOGY & INTERNAL MEDICINE PC
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Dates
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Enumeration Date | 02/22/2011
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Last Update Date | 02/22/2011
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Provider Practice Location Address
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Address Line | 577 S MAIN ST
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City | CHESHIRE
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State | CT
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Zip | 06410-3146
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Country | US
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Telephone | 203-272-1619
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Fax | 203-272-1610
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Provider Business Mailing Address
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Address Line | 577 S MAIN ST
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City | CHESHIRE
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State | CT
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Zip | 06410-3146
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Country | US
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Telephone | 203-272-1619
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Fax | 203-272-1610
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD D KAYNE
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Credential | MD
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Telephone | 203-272-1619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 019485
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 019485
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License Number State | CT
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