Provider Demographics
NPI:1871700575
Name:KDR FIRST ASSIST LLC
Entity type:Organization
Organization Name:KDR FIRST ASSIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:860-480-0163
Mailing Address - Street 1:75 E COTTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06057-3524
Mailing Address - Country:US
Mailing Address - Phone:860-480-0163
Mailing Address - Fax:860-489-3268
Practice Address - Street 1:75 E COTTON HILL RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06057-3524
Practice Address - Country:US
Practice Address - Phone:860-480-0163
Practice Address - Fax:860-489-3268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE38236163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty