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General NPI Number Information
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NPI Number | 1952955270
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Entity Type | Organization
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Legal Business Name | NEW DAY MEDICAL LLC
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 4655 N PT WASH RD
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City | GLENDALE
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State | WI
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Zip | 53212-1004
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Country | US
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Telephone | 414-708-4282
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Fax |
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Provider Business Mailing Address
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Address Line | 410 E SHOREWOOD BLVD.
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City | SHOREWOOD
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State | WI
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Zip | 53211
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Country | US
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Telephone | 414-708-4282
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Fax |
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Authorized Official
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Title or Position | SOLE PARTNER
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Name | GREGORY KAFTAN
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Credential | MD
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Telephone | 414-708-4282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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