Individual ProviderKaosoluchi EnenduPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address300 George St Ste 901, New Haven, CT 06511-6662(203) 785-2095PECOS EnrollmentBased on the most recent information from CMS, provider Kaosoluchi Enendu is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1184204695Provider TypeIndividualFull NameEnendu, KaosoluchiCredentialMDGenderFemaleSole ProprietorNoEnumeration Date4/9/2021Last Updated1/12/2026Contact InformationPractice LocationPractice Address300 George St Ste 901, New Haven, CT 06511-6662Phone(203) 785-2095FaxUnlisted FaxMailing LocationMailing Address300 George St Ste 901, New Haven, CT 06511-6662PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA197583CaliforniaCode2084P0800XDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicense75155ConnecticutCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer