Provider Demographics
NPI:1225009046
Name:ASTRACHAN, DAVID I (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:I
Last Name:ASTRACHAN
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 1:2200 WHITNEY AVE
Mailing Address - Street 2:STE 260
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3694
Mailing Address - Country:US
Mailing Address - Phone:203-248-8409
Mailing Address - Fax:203-281-2905
Practice Address - Street 1:2200 WHITNEY AVE
Practice Address - Street 2:STE 260
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3694
Practice Address - Country:US
Practice Address - Phone:203-248-8409
Practice Address - Fax:203-281-2905
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027670207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
010027670CT08OtherANTHEM BCBS OF CT
OQ1324OtherHEALTHNET
OQ1324OtherHEALTHNET