Provider Demographics
NPI:1790990943
Name:KEHOE, EILEEN (MD)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:KEHOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:455 LEWIS AVE. STE 214
Mailing Address - Street 2:CONNECTICUT NEPHROLOGY ASSOCIATES, LLC
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-2121
Mailing Address - Country:US
Mailing Address - Phone:203-237-6700
Mailing Address - Fax:203-237-6100
Practice Address - Street 1:455 LEWIS AVE.
Practice Address - Street 2:STE 214
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2121
Practice Address - Country:US
Practice Address - Phone:203-237-6700
Practice Address - Fax:203-237-6100
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2011-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT48033207R00000X, 208M00000X
CT048033207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist