Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 238623 | MA |
Y | 207YP0228X | Pediatric Otolaryngology | 048858 | CT |
NPI | 1982802666 |
---|---|
Provider Name | Dr. Katherine Reichmann Kavanagh |
First Address | Hartford, CT 06106-3322 |
Second Address | Hartford, CT 06106-3322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 13/05/2013 |