Provider Demographics
NPI:1801042551
Name:MANGAT, SUKHPAL SINGH (MD)
Entity Type:Individual
Prefix:
First Name:SUKHPAL
Middle Name:SINGH
Last Name:MANGAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PARROTT DR UNIT 1012
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4791
Mailing Address - Country:US
Mailing Address - Phone:716-866-0865
Mailing Address - Fax:
Practice Address - Street 1:100 PARROTT DR UNIT 1012
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4791
Practice Address - Country:US
Practice Address - Phone:716-866-0865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT051000207L00000X
FLME149874207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology