Provider Demographics
NPI:1780940759
Name:KAHN, ZACHARY A (DO)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:A
Last Name:KAHN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 HOPMEADOW ST
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1880
Mailing Address - Country:US
Mailing Address - Phone:860-408-3080
Mailing Address - Fax:860-408-3081
Practice Address - Street 1:995 HOPMEADOW ST
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-1880
Practice Address - Country:US
Practice Address - Phone:860-408-3080
Practice Address - Fax:860-408-3081
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT56064208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics