Provider Demographics
NPI:1881654291
Name:JOSHI, KAVITA (MD)
Entity Type:Individual
Prefix:
First Name:KAVITA
Middle Name:
Last Name:JOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9 TWINBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2042
Mailing Address - Country:US
Mailing Address - Phone:203-606-5951
Mailing Address - Fax:203-371-8006
Practice Address - Street 1:115 TECHNOLOGY DR
Practice Address - Street 2:SUITE B100
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6337
Practice Address - Country:US
Practice Address - Phone:203-606-5951
Practice Address - Fax:203-371-8006
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT040673207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001406736Medicaid
CT001406736Medicaid
CTH71945Medicare UPIN