Provider Demographics
NPI:1023033008
Name:PARIKH, DUSHYANT (MD)
Entity Type:Individual
Prefix:
First Name:DUSHYANT
Middle Name:
Last Name:PARIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 HAZARD AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4571
Mailing Address - Country:US
Mailing Address - Phone:860-749-8267
Mailing Address - Fax:
Practice Address - Street 1:146 HAZARD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4571
Practice Address - Country:US
Practice Address - Phone:860-749-8267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026394207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001263946Medicaid
CT061168347OtherTAX ID#
CT110001215Medicare PIN
CTD74023Medicare UPIN