Provider Demographics
NPI:1881094100
Name:VACHHANI, KEVIN
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:VACHHANI
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 1:23 WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-1737
Mailing Address - Country:US
Mailing Address - Phone:203-300-1704
Mailing Address - Fax:
Practice Address - Street 1:23 WILLOW CT
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-1737
Practice Address - Country:US
Practice Address - Phone:203-300-1704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist