MEDICARE: DR. RICHARD ALBERT CAGNA M.D.

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	207R00000X	Internal Medicine Physician	029821	CT

General Provider Information

NPI Number	:	1831153154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ALBERT CAGNA M.D.

Provider Business Mailing Address
First Line	:	2 CONCORDE WAY
Second Line	:
City	:	WINDSOR LOCKS
State	:	CT
Zip	:	06096-1577
Country	:	US
Telephone Number	:	860-627-0224
Fax Number	:	860-292-1270

Provider Business Practice Location Address
First Line	:	2 CONCORDE WAY
Second Line	:	BLDG 2
City	:	WINDSOR LOCKS
State	:	CT
Zip	:	06096-1576
Country	:	US
Telephone Number	:	860-627-0224
Fax Number	:	860-292-1270

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	11/11/2021

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