Provider Demographics
NPI:1619084365
Name:PHATAK, UMA PADHYE (MD)
Entity Type:Individual
Prefix:DR
First Name:UMA
Middle Name:PADHYE
Last Name:PHATAK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:333 CEDAR STREET
Mailing Address - Street 2:FMP 408
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520
Mailing Address - Country:US
Mailing Address - Phone:203-785-4649
Mailing Address - Fax:203-737-1384
Practice Address - Street 1:333 CEDAR STREET
Practice Address - Street 2:FMP 408
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520
Practice Address - Country:US
Practice Address - Phone:203-785-4649
Practice Address - Fax:203-737-1384
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT044227208000000X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001442277Medicaid
CT370001669Medicare PIN
CTI60789Medicare UPIN