Provider Demographics
NPI:1598743908
Name:KAVJIAN, DAVID ALAN (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:KAVJIAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 SILAS DEANE HIGHWAY
Mailing Address - Street 2:HHC - CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 GRAND ST # W1
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2016
Practice Address - Country:US
Practice Address - Phone:860-224-5261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53876207X00000X
VA0101040813207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
27306OtherALLIANCE PPO
27306OtherNDIPA
502707OtherAETNA US HEALTHCARE
VA006497853Medicaid
4091886OtherAETNA MANAGED CHOICE
1173529004OtherCIGNA HEALTHCARE
200013382OtherTRAVELERS MEDICARE
046068OtherHEALTHKEEPERS ANTHEM
046068053384OtherBCBS
1700800OtherUNITED HEALTH CARE
290290OtherAMERIGOUP MEDICAID
006497853OtherMEDALLION MEDICAL
25530018OtherCAPITAL CARE
27306OtherGALT EMPLOYEES HEALTH
540911540OtherTRICARE
25530018OtherCAREFIRST