Provider Demographics
NPI:1568457117
Name:KIER, RUBEN
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:KIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8082
Mailing Address - Country:US
Mailing Address - Phone:203-671-1922
Mailing Address - Fax:
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-1933
Practice Address - Country:US
Practice Address - Phone:203-671-1922
Practice Address - Fax:860-679-3145
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT280282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT061613357OtherCIGNA CT
CT300003077Medicaid
CT500HBX051CT01OtherBCBS CT
CT001280289-P2OtherBLUE CARE FAMILY PLAN
CTOV9113OtherHEALTH NET
CT2069098OtherUNITED HEALTHCARE
CT0086989OtherAETNA CT
CT300128652OtherRAILROAD MEDICARE
CTANC1162OtherOXFORD HEALTH PLANS
CT500HBX051CT01OtherBCBS CT
CT001280289-P2OtherBLUE CARE FAMILY PLAN