Provider Demographics
NPI:1558746289
Name:AAKAISH HEALTHCARE LLC
Entity Type:Organization
Organization Name:AAKAISH HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SRINIVASULU
Authorized Official - Middle Name:
Authorized Official - Last Name:CONJEEVARAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-207-2557
Mailing Address - Street 1:11 WINTHROP RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1656
Mailing Address - Country:US
Mailing Address - Phone:860-415-3622
Mailing Address - Fax:833-974-0884
Practice Address - Street 1:11 WINTHROP RD STE 2A
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-1656
Practice Address - Country:US
Practice Address - Phone:860-415-3622
Practice Address - Fax:833-974-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty