Provider Demographics
NPI:1851560411
Name:VEENA VANI, M.D., LLC
Entity Type:Organization
Organization Name:VEENA VANI, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:VEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-430-9004
Mailing Address - Street 1:935 MAIN ST
Mailing Address - Street 2:LEVEL A
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6059
Mailing Address - Country:US
Mailing Address - Phone:860-430-9004
Mailing Address - Fax:860-781-6468
Practice Address - Street 1:935 MAIN ST
Practice Address - Street 2:LEVEL A
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6059
Practice Address - Country:US
Practice Address - Phone:860-430-9004
Practice Address - Fax:860-781-6468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032532261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care