Provider Demographics
NPI:1790913697
Name:TRIVEDI, ANSHU (MB BS)
Entity Type:Individual
Prefix:DR
First Name:ANSHU
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:MB BS
Other - Prefix:DR
Other - First Name:ANSHU
Other - Middle Name:
Other - Last Name:AHLAWAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:47 AVONWOOD RD
Mailing Address - Street 2:APT. 320
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-2048
Mailing Address - Country:US
Mailing Address - Phone:860-970-9035
Mailing Address - Fax:
Practice Address - Street 1:80 SEYMOUR ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-545-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53174207ZP0102X, 207ZP0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program