MEDICARE: DR. KATHRYN M CAMBI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	040240	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	061511900	OTHER	CT	FEB TAX ID

General Provider Information

NPI Number	:	1720047285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN M CAMBI MD

Provider Business Mailing Address
First Line	:	PO BOX 340
Second Line	:
City	:	OLD LYME
State	:	CT
Zip	:	06371-0340
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	149D BOSTON POST RD
Second Line	:
City	:	OLD LYME
State	:	CT
Zip	:	06371-1348
Country	:	US
Telephone Number	:	203-623-6042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	07/03/2025

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