1801877162 NPI number — DR. KENNETH R KAPLAN MD

Table of content: DR. KENNETH R KAPLAN MD (NPI 1801877162)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801877162 NPI number — DR. KENNETH R KAPLAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAPLAN
Provider First Name:
KENNETH
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1801877162
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1849
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEWISTON
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04241-1849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-784-2554
Provider Business Mailing Address Fax Number:
207-777-5363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 PARK STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATTLEBORO
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02703-3143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-236-7750
Provider Business Practice Location Address Fax Number:
508-223-3026
Provider Enumeration Date:
11/14/2005

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: 2085R0202X , with the licence number:  75396 , 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: 410551 . This is a "BLUE CHIP R" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 04-3140277 . This is a "TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 00000002835 . This is a "HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 4700 . This is a "BCBS RI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: TUFTS HEALTH PLAN . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7803794003 . This is a "CIGNA MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J13152 . This is a "BCBS MA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 04-3140277 . This is a "HCVM FIRST HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 16-00012 . This is a "UNITED HEALTHCARE RI" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 244478 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 300134591 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MP ) . This identifiers is of the category "OTHER".
  • Identifier: 3095096 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00601386 . This is a "RR MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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