Provider Demographics
NPI:1093784589
Name:KAHANER, HARVEY ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:ALLEN
Last Name:KAHANER
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 1:239 LUDLOW RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4546
Mailing Address - Country:US
Mailing Address - Phone:860-646-7245
Mailing Address - Fax:860-646-7245
Practice Address - Street 1:239 LUDLOW RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4546
Practice Address - Country:US
Practice Address - Phone:860-646-7245
Practice Address - Fax:860-646-7245
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT15095207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB38810Medicare UPIN
CT15095Medicare ID - Type UnspecifiedSTATE LICENSE