Provider Demographics
NPI:1760446025
Name:KAFER, SHELDON (MD)
Entity Type:Individual
Prefix:MR
First Name:SHELDON
Middle Name:
Last Name:KAFER
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 1:2 CONCORDE WAY
Mailing Address - Street 2:#2
Mailing Address - City:WINDSOR LOCKS
Mailing Address - State:CT
Mailing Address - Zip Code:06096
Mailing Address - Country:US
Mailing Address - Phone:860-627-0224
Mailing Address - Fax:860-292-1270
Practice Address - Street 1:2 CONCORDE WAY
Practice Address - Street 2:#2
Practice Address - City:WINDSOR LOCKS
Practice Address - State:CT
Practice Address - Zip Code:06096
Practice Address - Country:US
Practice Address - Phone:860-627-0224
Practice Address - Fax:860-292-1270
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173000000X
CT027500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTE13883Medicare UPIN