Connor Cackovic, DO

Individual provider Active NPI Undersea and Hyperbaric Medicine (Preventive Medicine) Physician · Kittery, ME

NPI 1336907906 · NPPES record last updated Mar 5, 2026

Key facts

NPI
1336907906
Entity type
Individual (NPI type 1)
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X
License
011862 (AZ)
Practice address
402 Goodrich Ave
Kittery, ME 03904
Phone
(888) 628-9633
NPI assigned
Mar 8, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
011862AZMDUndersea and Hyperbaric Medicine (Preventive Medicine) Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 011862 AZ Yes

Addresses

Primary practice location

402 Goodrich Ave
Kittery, ME 03904

Mailing address

402 Goodrich Avenue
Kittery, ME 03904

Other providers in Kittery, ME

All providers in Kittery, ME · Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Maine

Sources for this page

Verify at the official NPI Registry.