Shushtari, J Kevin

Shushtari, J Kevin is an sole proprietor health care provider with primary practice located at 326 Washington St , Norwich CT 06360-2740. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Shushtari, J Kevin can be contacted via phone (941) 917-4896.

Contact Information

Primary practice address
326 Washington St Norwich CT 06360-2740
Phone: (941) 917-4896
Fax: (941) 917-6884
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME121844 Florida
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036002 Connecticut

Profile Details

NPI number 1417923160
LBN Legal business name Shushtari, J Kevin
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2006
Last updated Oct 13th, 2017 - about 7 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 1417923160 NPPES
Other 3114253 AETNA
MEDICAID 001360023 AETNA
Other 110247602 AETNA
Other 1221925 AETNA
Other 010036002CT01 AETNA
Other 2V2738 AETNA
Other P2832183 AETNA

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