Provider Demographics
NPI:1568455137
Name:KAPLAN, JERROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:JERROLD
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 WHITNEY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3691
Mailing Address - Country:US
Mailing Address - Phone:203-407-7727
Mailing Address - Fax:203-407-4393
Practice Address - Street 1:2200 WHITNEY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3691
Practice Address - Country:US
Practice Address - Phone:203-407-7727
Practice Address - Fax:203-407-4393
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT032371208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT250000420Medicare PIN