Provider Demographics
NPI:1972527158
Name:KERSHEN, RICHARD TODD (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:TODD
Last Name:KERSHEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:85 SEYMOUR STREET, SUITE 416
Mailing Address - Street 2:HHMG UROLOGY INSTITUTE
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-947-8500
Mailing Address - Fax:860-524-8643
Practice Address - Street 1:85 SEYMOUR STREET, SUITE 416
Practice Address - Street 2:HHMG UROLOGY INSTITUTE
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-947-8500
Practice Address - Fax:860-524-8643
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2015-02-04
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Provider Licenses
StateLicense IDTaxonomies
VT042-0010577208800000X
CT050730208800000X, 2088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02428595Medicaid
VT1009694Medicaid
VT1009694Medicaid
CTD400081329Medicare PIN