KENNETH J EGAN (NPI# 1518042092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518042092 |
| Entity Type | Individual |
| Full Name | KENNETH J EGAN |
| Credential | MD |
| Practice Address |
107 Newtown Rd Suite 2c Danbury CT 06810-4146 |
| Practice Telephone | 2037908930 |
| Practice Fax Number | 2037908930 |
| Mailing Telephone | 2037908930 |
| Mailing Fax Number | 2037908930 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2013-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 029527 | CT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275698862 | Kenneth M Egan | Pediatrics | Rr 1 Box 3060, Clinton, OK 73601-9303 | 2006-12-26 |
| Street Address |
107 NEWTOWN RD SUITE 2C |
| City | DANBURY |
| State | CT |
| Zip Code | 06810-4146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184629545 | David Goldenberg | Specialist | 107 Newtown Rd, 2c, Danbury, CT 06810-4146 | 2005-06-14 |
| 1669815114 | Maryam Azizi | Pediatrics | 107 Newtown Rd, Danbury, CT 06810-4146 | 2013-04-15 |
| 1689957045 | Melissa T Lev | Audiologist | 107 Newtown Rd, Suite 2a, Danbury, CT 06810-4146 | 2011-09-22 |
| 1881981371 | Michael Drobbin | Otolaryngology | 107 Newtown Rd, Suite 2a, Danbury, CT 06810-4146 | 2011-07-05 |
| 1861630790 | Karen A Sample | Audiologist | 107 Newtown Rd, Danbury, CT 06810-4146 | 2009-01-30 |
| 1275791279 | Yogen Dave | Allergy & Immunology | 107 Newtown Rd, Danbury, CT 06810-4146 | 2008-05-27 |
| 1861677031 | Advanced Audiology & Hearing Aid Services | Audiologist-Hearing Aid Fitter | 107 Newtown Rd, Suite 2a, Danbury, CT 06810-4146 | 2008-01-07 |
| 1760692941 | Purvi Shah | Specialist | 107 Newtown Rd, 1b, Danbury, CT 06810-4146 | 2007-05-23 |
| 1245367622 | Anthony Joseph Camillo | Dentist | 107 Newtown Rd, Danbury, CT 06810-4146 | 2007-02-27 |
| 1992843908 | Dayna Nethercott | Physician Assistant | 107 Newtown Rd, Suite 1d, Danbury, CT 06810-4146 | 2007-02-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235751017 | Jai Karan Singh | Student in an Organized Health Care Education/Training Program | 120 Main Street, Connecticut Institute of Communities, Danbury, CT 06810 | 2020-05-14 |
| 1497377576 | Jahangir Rouzbehani Selakhor | Student in an Organized Health Care Education/Training Program | 24 Hospital Ave. 06810-6099, Danbury, CT 06810 | 2020-05-12 |
| 1255984043 | Michelle Jean Moore | Nurse Practitioner | 95 Locust Avenue 1st Floor Oncology, Stroock Building, Danbury, CT 06810 | 2019-07-20 |
| 1740748755 | Jose Rafael Rivera | Pharmacist | 305 White St, Danbury, CT 06810 | 2019-03-08 |
| 1013406396 | Aswathi Elsa Mathew | Student in an Organized Health Care Education/Training Program | Greater Danbury Community Health Center, 120 Main St, Danbury, CT 06810 | 2018-05-02 |
| 1073001772 | Manish Kumar Gupta | Student in an Organized Health Care Education/Training Program | Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810 | 2018-04-27 |
| 1396232005 | Ayushman Rai Sood | Student in an Organized Health Care Education/Training Program | 24 Hospital Avenue, Danbury Hospital, Danbury, CT 06810 | 2018-04-18 |
| 1366953705 | Connecticut Neurodiagnostics, LLC | Clinic/Center | 83 Wooster Heights Rd., Suite 125, Office 145, Danbury, CT 06810 | 2017-10-12 |
| 1528585569 | Xing Zhu | Dentist | 28 Paulding Ter, Danbury, CT 06810 | 2017-08-29 |
| 1851812606 | Julie Susanne Alferi | Dental Hygienist | 70, Main Street, Danbury, CT 06810 | 2017-07-02 |
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| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659324515 | Michael Stanley Thibault | Dermatology | 25 Tamarack Avenue, Advanced Derm Care, PC, Danbury, CT 06811 | 2006-05-19 |
| 1023068087 | Advanced Derm Care PC | Dermatology | 25 Tamarack Ave, Advanced Derm Care PC, Danbury, CT 06811 | 2006-05-11 |
| 1285636498 | Kenneth A Cohen | Dermatology | 73 Sand Pit Rd, Ste 207, Danbury, CT 06810-4015 | 2005-06-01 |
| 1871596544 | Stuart A Kittay | Dermatology | 16 Hospital Ave, Ste 302, Danbury, CT 06810-5994 | 2005-05-24 |
| 1164719043 | Marimeg Quinn Clairwood | Dermatology | 25 Tamarack Ave, Danbury, CT 06811-4829 | 2011-06-29 |
| 1144255332 | William A Notaro | Dermatology | 27 Hospital Ave, Suite 406, Danbury, CT 06810-5954 | 2006-07-12 |
| 1922059823 | Barry S Goldberg | Dermatology | 25 Tamarack Ave, Advanced Derm Care PC, Danbury, CT 06811 | 2006-05-15 |
| 1033160924 | Grace L Federman | Dermatology | 25 Tamarack Ave, Advanced Derm Care PC, Danbury, CT 06811 | 2006-05-15 |
| 1306896287 | Jonathan R Zirn | Dermatology | 25 Tamarack Ave, Advanced Derm Care PC, Danbury, CT 06811-4829 | 2006-05-11 |
| 1679523450 | Mona A Gohara | Dermatology | 25 Tamarack Ave, Advanced Derm Care PC, Danbury, CT 06811 | 2006-05-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.