Provider Demographics
NPI:1346275542
Name:KAYAL, FREDERICK ABRAHAM (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:ABRAHAM
Last Name:KAYAL
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 1:300 FEDERAL RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2412
Mailing Address - Country:US
Mailing Address - Phone:203-775-0010
Mailing Address - Fax:
Practice Address - Street 1:300 FEDERAL RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2412
Practice Address - Country:US
Practice Address - Phone:203-775-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT01614207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B84516Medicare UPIN