Provider Demographics
NPI:1629652706
Name:SHEKHAR, RAJ (MBBS)
Entity Type:Individual
Prefix:
First Name:RAJ
Middle Name:
Last Name:SHEKHAR
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UCONN SCHOOL OF MEDICINE-GRADUATE MEDICAL EDUCATION
Mailing Address - Street 2:263 FARMINGTON AVENUE -LM068
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-1921
Mailing Address - Country:US
Mailing Address - Phone:860-679-2147
Mailing Address - Fax:860-679-4624
Practice Address - Street 1:BURGDORF CLINIC
Practice Address - Street 2:131 COVENTRY ST, 2ND FLOOR
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112
Practice Address - Country:US
Practice Address - Phone:860-714-3690
Practice Address - Fax:860-714-8541
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2022-07-18
Deactivation Date:2022-05-06
Deactivation Code:
Reactivation Date:2022-07-18
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program