Kantorovich, Vitaly

Kantorovich, Vitaly is an individual health care provider with primary practice located at 263 Farmington Ave , Farmington CT 06030-5351. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Kantorovich, Vitaly can be contacted via phone (860) 679-3245.

Contact Information

Primary practice address
263 Farmington Ave Farmington CT 06030-5351
Phone: (860) 679-3245
Fax: (860) 679-1867
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 051169 Connecticut

Profile Details

NPI number 1902914724
LBN Legal business name Kantorovich, Vitaly
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Aug 9th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902914724 NPPES
Connecticut MEDICAID 1902914724

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