Provider Demographics
NPI:1083703367
Name:KANE, MICHAEL P (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:KANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 SAND PIT RD STE 204
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4015
Mailing Address - Country:US
Mailing Address - Phone:203-212-8000
Mailing Address - Fax:860-261-0407
Practice Address - Street 1:73 SAND PIT RD STE 204
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4015
Practice Address - Country:US
Practice Address - Phone:203-212-8000
Practice Address - Fax:860-261-0704
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU56444Medicare UPIN
CTU56444Medicare UPIN