IndividualActive
Kenderick Street, IDC
NPI 1972098184 · Other Technician · New Haven, CT
Provider details
- NPI number
- 1972098184
- Entity type
- Individual
- Primary specialty
- Other TechnicianTechnologists, Technicians & Other Technical Service Providers
- Credential
- IDC
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
503 Townsend Ave
New Haven, CT 06512-3653
Phone: (912) 331-3110
Approximate (ZIP-level) locationGet directions
Mailing address
503 Townsend Ave
New Haven, CT 06512-3653
Registry dates
- Enumerated
- 2018-06-29
- Last updated
- 2018-06-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.