Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 63924 | CT |
Y | 2080P0201X | Pediatric Allergist | 63924 | CT |
NPI | 1831552546 |
---|---|
Provider Name | Kelsey Kaman |
First Address | South Windsor, CT 06074-1711 |
Second Address | West Hartford, CT 06119-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2016 |
Last Update Date | 21/07/2021 |