Provider Demographics
NPI:1508801309
Name:BAKHRU, MADHURI NANIK (MD)
Entity Type:Individual
Prefix:DR
First Name:MADHURI
Middle Name:NANIK
Last Name:BAKHRU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 HOSPITAL AVE
Mailing Address - Street 2:SUIET #201
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5954
Mailing Address - Country:US
Mailing Address - Phone:203-743-9550
Mailing Address - Fax:
Practice Address - Street 1:27 HOSPITAL AVE
Practice Address - Street 2:SUITE # 201
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5954
Practice Address - Country:US
Practice Address - Phone:203-743-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT18193207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001181932Medicaid
CTD01053Medicare UPIN
CT160000360Medicare PIN