Doctor Name: | KEVIN DICKEY |
NPI Number: | 1639150055 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 032097 |
Business Practice Address: | 100 Grand St New Britain, CT - 060522016 |
Business Phone Number: | 8602245556 |
Business Fax Number: | 8602295642 |
Mailing Address: | 1 Liberty Sq, Po Box 217 NEW BRITAIN |
State: | CT |
Postal Code: | 060512637 |
Phone Number: | 8608270071 |
Fax Number: | 8602295642 |
NPI Enumeration Date: | 11/11/2005 |
NPI Last Update Date: | 03/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 032097 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |