1598743908 NPI number — DAVID ALAN KAVJIAN MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598743908 NPI number — DAVID ALAN KAVJIAN MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KAVJIAN

Provider First Name:

DAVID

Provider Middle Name:

ALAN

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1598743908

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/17/2025

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1290 SILAS DEANE HWY

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

WETHERSFIELD

Provider Business Mailing Address State Name:

CT

Provider Business Mailing Address Postal Code:

06109-4337

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

100 GRAND ST # W1

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

NEW BRITAIN

Provider Business Practice Location Address State Name:

CT

Provider Business Practice Location Address Postal Code:

06052-2016

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

860-224-5261

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

01/05/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207X00000X , with the licence number:  0101040813 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207X00000X , with the licence number: 53876 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 207X00000X , with the licence number: 25IA12934300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 27306 . This is a "NDIPA" identifier . This identifiers is of the category "OTHER".
• Identifier: 27306 . This is a "ALLIANCE PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 502707 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 006497853 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
• Identifier: 4091886 . This is a "AETNA MANAGED CHOICE" identifier . This identifiers is of the category "OTHER".
• Identifier: 1173529004 . This is a "CIGNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 200013382 . This is a "TRAVELERS MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 046068 . This is a "HEALTHKEEPERS ANTHEM" identifier . This identifiers is of the category "OTHER".
• Identifier: 046068053384 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
• Identifier: 1700800 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 290290 . This is a "AMERIGOUP MEDICAID" identifier . This identifiers is of the category "OTHER".
• Identifier: 006497853 . This is a "MEDALLION MEDICAL" identifier . This identifiers is of the category "OTHER".
• Identifier: 25530018 . This is a "CAPITAL CARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 27306 . This is a "GALT EMPLOYEES HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 540911540 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 25530018 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".