Provider Demographics
NPI:1164587564
Name:MUKHOPADHYAY, BIJAY (MD)
Entity Type:Individual
Prefix:
First Name:BIJAY
Middle Name:
Last Name:MUKHOPADHYAY
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:JOHN DEMPSEY HOSPITAL
Mailing Address - Street 2:263 FARMINGTON AVENUE, MC-3210
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-0001
Mailing Address - Country:US
Mailing Address - Phone:860-679-4236
Mailing Address - Fax:
Practice Address - Street 1:JOHN DEMPSEY HOSPITAL
Practice Address - Street 2:263 FARMINGTON AVENUE, MC-3210
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-0001
Practice Address - Country:US
Practice Address - Phone:860-679-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021914207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology