Provider Demographics
NPI:1427343722
Name:KANAHARA, SATOKO (MD)
Entity type:Individual
Prefix:
First Name:SATOKO
Middle Name:
Last Name:KANAHARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4102
Mailing Address - Country:US
Mailing Address - Phone:203-438-6541
Mailing Address - Fax:
Practice Address - Street 1:21 SOUTH ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4102
Practice Address - Country:US
Practice Address - Phone:203-438-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281649207R00000X, 208000000X
CT80252208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331946Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY00695941Medicaid
NY331043Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NY331954Medicare Oscar/Certification