Provider Demographics
NPI:1093777948
Name:LIMAYE, DEEPA (MD)
Entity Type:Individual
Prefix:
First Name:DEEPA
Middle Name:
Last Name:LIMAYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2479
Mailing Address - Country:US
Mailing Address - Phone:860-676-9000
Mailing Address - Fax:860-676-1541
Practice Address - Street 1:200 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2479
Practice Address - Country:US
Practice Address - Phone:860-676-9000
Practice Address - Fax:860-676-1541
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037231208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics