Active NPI
Kevin Michael Diette, M.D.
- Dermatology Physician
- Milford, CT
National Provider Identifier
1447252812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 024290
- Practice address
- 88 Noble Ave
Milford, CT 06460-4738 - Phone
- (203) 878-3435
- Fax
- (203) 783-9689
- NPI assigned
- Aug 15, 2005
- Last updated
- Oct 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 024290 | CT | Primary |
Addresses
Primary practice location
88 Noble Ave
Milford, CT 06460-4738
Mailing address
88 Noble Ave
Milford, CT 06460-4738
Phone (203) 878-3435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024290 | CT | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1447252812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 NOBLE AVE",
"city": "MILFORD",
"state": "CT",
"postal_code": "064604738",
"telephone_number": "203-878-3435",
"fax_number": "203-783-9689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 NOBLE AVE",
"city": "MILFORD",
"state": "CT",
"postal_code": "064604738",
"telephone_number": "203-878-3435",
"fax_number": "203-783-9689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETTE",
"first_name": "KEVIN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CT",
"license": "024290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.