Provider Demographics
NPI:1346439122
Name:REKHA RANADE-KAPUR, M.D.,R.R.K.,LLC
Entity Type:Organization
Organization Name:REKHA RANADE-KAPUR, M.D.,R.R.K.,LLC
Other - Org Name:R.R.K.,LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANADE-KAPUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-721-7911
Mailing Address - Street 1:185 SILAS DEANE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109
Mailing Address - Country:US
Mailing Address - Phone:860-721-7911
Mailing Address - Fax:860-257-0272
Practice Address - Street 1:185 SILAS DEANE HIGHWAY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109
Practice Address - Country:US
Practice Address - Phone:860-721-7911
Practice Address - Fax:860-257-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT20514261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1205146Medicaid
CT1205146Medicaid