Provider Demographics
NPI:1548620032
Name:KANE, ANDREW (CRNA)
Entity type:Individual
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First Name:ANDREW
Middle Name:
Last Name:KANE
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:2 TRAP FALLS RD
Mailing Address - Street 2:SUITE 414
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4616
Mailing Address - Country:US
Mailing Address - Phone:203-929-7353
Mailing Address - Fax:203-929-0756
Practice Address - Street 1:99 E RIVER DR
Practice Address - Street 2:5TH FLOOR
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3288
Practice Address - Country:US
Practice Address - Phone:860-282-0833
Practice Address - Fax:860-282-0170
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2017-01-17
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Provider Licenses
StateLicense IDTaxonomies
CT106232367500000X
CT6544367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered