Provider Demographics
NPI:1447213491
Name:JAIN, HIRA C (MD)
Entity Type:Individual
Prefix:DR
First Name:HIRA
Middle Name:C
Last Name:JAIN
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 1:153 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-3112
Mailing Address - Country:US
Mailing Address - Phone:860-646-2345
Mailing Address - Fax:860-646-2345
Practice Address - Street 1:153 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-3112
Practice Address - Country:US
Practice Address - Phone:860-646-2345
Practice Address - Fax:860-646-2345
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0279862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry