Provider Demographics
NPI:1356575716
Name:EK, KIRSTEN LEE (MD)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LEE
Last Name:EK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-2212
Mailing Address - Country:US
Mailing Address - Phone:860-679-7503
Mailing Address - Fax:860-679-1610
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-6227
Practice Address - Country:US
Practice Address - Phone:860-679-4477
Practice Address - Fax:860-679-4474
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2022-09-26
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Provider Licenses
StateLicense IDTaxonomies
CT051449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine