1467455352 NPI number — DR. ROBERT LEE KANE D.C.

Table of content: DR. ROBERT LEE KANE D.C. (NPI 1467455352)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467455352 NPI number — DR. ROBERT LEE KANE D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KANE
Provider First Name:
ROBERT
Provider Middle Name:
LEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KANE
Provider Other First Name:
LEE
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1467455352
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
228 TRIANGLE ST
Provider Second Line Business Mailing Address:
STE 4
Provider Business Mailing Address City Name:
AMHERST
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01002-2169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-549-1500
Provider Business Mailing Address Fax Number:
413-549-7535

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
228 TRIANGLE ST
Provider Second Line Business Practice Location Address:
STE 4
Provider Business Practice Location Address City Name:
AMHERST
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01002-2169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-549-1500
Provider Business Practice Location Address Fax Number:
413-549-7535
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1272 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 13472 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 350139 . This is a "HARVARDPILGRIM HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1611941 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001272 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com