Provider Demographics
NPI:1982709630
Name:KAYNE, RICHARD D (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:KAYNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 SO MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410
Mailing Address - Country:US
Mailing Address - Phone:203-272-1619
Mailing Address - Fax:203-272-1610
Practice Address - Street 1:577 SO MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410
Practice Address - Country:US
Practice Address - Phone:203-272-1619
Practice Address - Fax:203-272-1610
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT019485CT207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
710126OtherCT CARE
CT001194851Medicaid
010019485CT07OtherANTHEM
110007737Medicare ID - Type Unspecified
710126OtherCT CARE