Provider Demographics
NPI:1346328044
Name:MAHABIR, RABINDRANATH (MD)
Entity Type:Individual
Prefix:DR
First Name:RABINDRANATH
Middle Name:
Last Name:MAHABIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:MAHABIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-1990
Mailing Address - Country:US
Mailing Address - Phone:203-888-9940
Mailing Address - Fax:203-888-2499
Practice Address - Street 1:100 OXFORD RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:CT
Practice Address - Zip Code:06478-1990
Practice Address - Country:US
Practice Address - Phone:203-888-9940
Practice Address - Fax:203-888-2499
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1340223Medicaid
CTF96169Medicare UPIN
CT1340223Medicaid