Provider Demographics
NPI:1235177767
Name:KHACHANE, VASANT B (MD)
Entity Type:Individual
Prefix:
First Name:VASANT
Middle Name:B
Last Name:KHACHANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 WHITNEY AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3691
Mailing Address - Country:US
Mailing Address - Phone:203-407-2500
Mailing Address - Fax:203-407-2500
Practice Address - Street 1:2200 WHITNEY AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3691
Practice Address - Country:US
Practice Address - Phone:203-407-2500
Practice Address - Fax:203-407-2500
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT16376174400000X, 208G00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1163765Medicaid
CT1163765Medicaid
CT330000032Medicare ID - Type Unspecified