Provider Demographics
NPI:1538116348
Name:PAREKH, ANISHA RAJESH (MD)
Entity Type:Individual
Prefix:
First Name:ANISHA
Middle Name:RAJESH
Last Name:PAREKH
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 1:48 DAISY HILL RD
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CT
Mailing Address - Zip Code:06370-1753
Mailing Address - Country:US
Mailing Address - Phone:860-442-4909
Mailing Address - Fax:
Practice Address - Street 1:8 VISTA DR
Practice Address - Street 2:EASTPORT NORTH BUSINESS PARK
Practice Address - City:OLD LYME
Practice Address - State:CT
Practice Address - Zip Code:06371-1537
Practice Address - Country:US
Practice Address - Phone:860-434-8847
Practice Address - Fax:860-434-0428
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2V0400OtherHEALTHNET PROVIDER ID
010039730CT01OtherANTHEM PROVIDER ID
CT080001522Medicare ID - Type Unspecified
H51568Medicare UPIN