Provider Demographics
NPI:1417956012
Name:LENHART, KEVIN K (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:K
Last Name:LENHART
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 1:251 W MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4047
Mailing Address - Country:US
Mailing Address - Phone:203-315-5300
Mailing Address - Fax:203-315-5312
Practice Address - Street 1:251 W MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4047
Practice Address - Country:US
Practice Address - Phone:203-315-5300
Practice Address - Fax:203-315-5312
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030100207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400133908Medicare PIN
CTE42357Medicare UPIN
CT060001216Medicare ID - Type Unspecified