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General NPI Number Information
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NPI Number | 1982005047
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Entity Type | Individual
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Provider Name | ANDREW DOUGLAS KASS APN
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Gender | Male
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 230 WATERFORD PKWY S
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City | WATERFORD
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State | CT
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Zip | 06385-1219
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Country | US
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Telephone | 860-444-3744
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Fax | 860-271-4958
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Provider Business Mailing Address
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Address Line | 230 WATERFORD PKWY S
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City | WATERFORD
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State | CT
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Zip | 06385-1219
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Country | US
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Telephone | 860-444-3744
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Fax | 860-271-4958
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11317
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License Number State | CT
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