Provider Demographics
NPI:1881666881
Name:DUA, NEERU C (MD)
Entity Type:Individual
Prefix:DR
First Name:NEERU
Middle Name:C
Last Name:DUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:836 FARMINGTON AVE STE 121
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1544
Mailing Address - Country:US
Mailing Address - Phone:860-233-9671
Mailing Address - Fax:860-236-3607
Practice Address - Street 1:836 FARMINGTON AVE STE 121
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1544
Practice Address - Country:US
Practice Address - Phone:860-233-9671
Practice Address - Fax:860-236-3607
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT042052207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001420520Medicaid
CTD400006644Medicare PIN
H28436Medicare UPIN