Provider Demographics
NPI:1407854276
Name:KUDLER, ALAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:KUDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 KENSINGTON AVE
Mailing Address - Street 2:GROVE HILL MEDICAL CENTER
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-223-0220
Mailing Address - Fax:860-826-4962
Practice Address - Street 1:1 LAKE ST
Practice Address - Street 2:GROVE HILL MEDICAL CENTER
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1396
Practice Address - Country:US
Practice Address - Phone:860-223-0220
Practice Address - Fax:860-826-4962
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT021718207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1255448155OtherGHMC GRP NPI ID
CT5240601OtherCONNECTICARE PROV ID
CT135460OtherWELLCARE MEDICARE
CT01021718OtherCIGNA PROV ID
CTP369906OtherOXFORD PROV ID
CT001217181Medicaid
CT060049OtherHEALTH NET PROV ID
CT481464OtherAETNA PROV ID
CT912449OtherHEALTH NET REF ID
CT004214459Medicaid
CT481464OtherAETNA PROV ID
CT912449OtherHEALTH NET REF ID
CT1255448155OtherGHMC GRP NPI ID