Provider Demographics
NPI:1760497622
Name:BELTANGADY, SHAMAL SRIRAMMOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAMAL
Middle Name:SRIRAMMOHAN
Last Name:BELTANGADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHAMALA
Other - Middle Name:ANANT
Other - Last Name:LABADAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MB BS
Mailing Address - Street 1:255 HEMPSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-6204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 VAUXHALL ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320
Practice Address - Country:US
Practice Address - Phone:860-442-2797
Practice Address - Fax:860-701-3776
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0281762084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry