Provider Demographics
NPI:1033104245
Name:KUROWSKI, KATHLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:KUROWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHAWS COVE,
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320
Mailing Address - Country:US
Mailing Address - Phone:860-440-3070
Mailing Address - Fax:860-444-7692
Practice Address - Street 1:4 SHAWS COVE,
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320
Practice Address - Country:US
Practice Address - Phone:860-440-3070
Practice Address - Fax:860-444-7692
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033630208600000X
CTBK4017744208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001336305Medicaid
CT020001344Medicare PIN
CTF81390Medicare UPIN
CT001336305Medicaid