Provider Demographics
NPI:1053572271
Name:WRIGHT, KERRY (DO)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5520 PARK AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-3463
Mailing Address - Country:US
Mailing Address - Phone:845-418-0763
Mailing Address - Fax:203-396-0699
Practice Address - Street 1:5520 PARK AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-3463
Practice Address - Country:US
Practice Address - Phone:845-418-0763
Practice Address - Fax:203-396-0699
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY255686207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400074846OtherMEDICARE PROVIDER ID