Provider Demographics
NPI:1063493401
Name:KAHAN, RONALD STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:STEVEN
Last Name:KAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CROSS ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-4647
Mailing Address - Country:US
Mailing Address - Phone:203-847-1500
Mailing Address - Fax:203-845-8764
Practice Address - Street 1:40 CROSS ST
Practice Address - Street 2:SUITE 340
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4647
Practice Address - Country:US
Practice Address - Phone:203-847-1500
Practice Address - Fax:203-845-8764
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT018641207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B38594Medicare UPIN
CT070000163Medicare ID - Type Unspecified