Provider Demographics
NPI:1629325394
Name:ROY, BHASKAR (MBBS)
Entity Type:Individual
Prefix:DR
First Name:BHASKAR
Middle Name:
Last Name:ROY
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:900 CHAPEL ST APT 508
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2817
Mailing Address - Country:US
Mailing Address - Phone:857-445-9112
Mailing Address - Fax:203-785-4937
Practice Address - Street 1:800 HOWARD AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-4085
Practice Address - Fax:203-785-4937
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT567132084B0040X, 2084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry