Provider Demographics
NPI:1932107851
Name:KAPLAN, KEITH A (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:KAPLAN
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 1:300 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-826-4453
Mailing Address - Fax:860-826-6219
Practice Address - Street 1:1 LAKE ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1396
Practice Address - Country:US
Practice Address - Phone:860-826-4453
Practice Address - Fax:860-826-6219
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028317208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060068OtherHEALTH NET PROV ID
CT010028317CT01OtherBCBS N BCFP PRIM ID
CT010028317CT04OtherBCBS N BCFP 2LOCA PROV ID
CT01028317OtherCIGNA PROV ID
CT1255448155OtherGHMC GRP NPI ID
CT340010375OtherRAIL ROAD MEDICARE ID
CT912457OtherHEALTH NET REF ID
CT135455OtherWELLCARE MEDICARE
CTP369843OtherOXFORD PROV ID
CT001283176Medicaid
CT004214467Medicaid
CT71678001OtherCONNECTICARE PROV ID
CT70801OtherAETNA REF ID
CT912457OtherHEALTH NET REF ID
CT1255448155OtherGHMC GRP NPI ID
E78574Medicare UPIN