Provider Demographics
NPI:1548572720
Name:KOIRALA, BINAYAK PRASAD (MD)
Entity Type:Individual
Prefix:DR
First Name:BINAYAK
Middle Name:PRASAD
Last Name:KOIRALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6 FIELDSTONE CMNS
Mailing Address - Street 2:SUITE D
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-3419
Mailing Address - Country:US
Mailing Address - Phone:860-875-2099
Mailing Address - Fax:860-872-3021
Practice Address - Street 1:6 FIELDSTONE CMNS
Practice Address - Street 2:SUITE D
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-3419
Practice Address - Country:US
Practice Address - Phone:860-875-2099
Practice Address - Fax:860-872-3021
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT052870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2720OtherLAST FOUR NPI