Kulakov, Slava I

Kulakov, Slava I is an individual health care provider with primary practice located at 134 Round Hill Rd , Fairfield CT 06824. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kulakov, Slava I can be contacted via phone (203) 255-0695.

Contact Information

Primary practice address
134 Round Hill Rd Fairfield CT 06824
Phone: (203) 255-0695
Fax: (203) 255-0629
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036896 Connecticut

Profile Details

NPI number 1073524104
LBN Legal business name Kulakov, Slava I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Jun 25th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073524104 NPPES
Connecticut MEDICAID 001368960
Connecticut Other 010036896CT01
Connecticut Other OV4890

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