Provider Demographics
NPI:1730120494
Name:ROY, PRIYA P (MD)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:P
Last Name:ROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PRIYANKA
Other - Middle Name:
Other - Last Name:ROY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:300 KENSINGTON AVE
Mailing Address - Street 2:GROVE HILL MEDICAL CENTER
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-801-6759
Mailing Address - Fax:860-348-4873
Practice Address - Street 1:300 KENSINGTON AVE
Practice Address - Street 2:GROVE HILL MEDICAL CENTER
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-3916
Practice Address - Country:US
Practice Address - Phone:860-832-8150
Practice Address - Fax:860-348-4873
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047089208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1596801OtherHIGHMARK BLUE SHIELD
1544939OtherGATEWAY HEALTH PLAN
PA1012114140005Medicaid
184635OtherUNISON
20051965OtherAMERIHEALTH MERCY
50059750OtherCBC
2274055000OtherIBC
50059750OtherCBC
PAP00357969Medicare PIN
PA078064HR2Medicare PIN