Provider Demographics
NPI:1497752802
Name:NIRANJAN, SANKAR N (MD)
Entity Type:Individual
Prefix:DR
First Name:SANKAR
Middle Name:N
Last Name:NIRANJAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NIRANJAN
Other - Middle Name:
Other - Last Name:SANKARANARAYANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:35 JOLLEY DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3062
Mailing Address - Country:US
Mailing Address - Phone:860-769-9866
Mailing Address - Fax:860-769-7300
Practice Address - Street 1:35 JOLLEY DR
Practice Address - Street 2:SUITE 203
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3062
Practice Address - Country:US
Practice Address - Phone:860-769-9866
Practice Address - Fax:860-769-7300
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041816207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001418161Medicaid
CT001418161Medicaid
CT001418161Medicaid