Provider Demographics
NPI:1609075324
Name:LODATO, CAROLINE KIERNAN (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:KIERNAN
Last Name:LODATO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:ANN
Other - Last Name:KIERNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 PERRYRIDGE RD
Mailing Address - Street 2:GREENWICH HOSPITAL
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-4697
Mailing Address - Country:US
Mailing Address - Phone:203-863-3840
Mailing Address - Fax:203-863-3467
Practice Address - Street 1:5 PERRYRIDGE RD
Practice Address - Street 2:GREENWICH HOSPITAL
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4697
Practice Address - Country:US
Practice Address - Phone:203-863-3840
Practice Address - Fax:203-863-3467
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15760207R00000X
CT051759207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine