Provider Demographics
NPI:1306730353
Name:KENDALL BURAIMOH PHYSIATRY
Entity type:Organization
Organization Name:KENDALL BURAIMOH PHYSIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSIATRY/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURAIMOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-624-1456
Mailing Address - Street 1:195 STEELE RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1050
Mailing Address - Country:US
Mailing Address - Phone:443-624-1456
Mailing Address - Fax:
Practice Address - Street 1:581 POQUONOCK AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2202
Practice Address - Country:US
Practice Address - Phone:860-688-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty