Provider Demographics
NPI:1912561358
Name:RANDHAWA, RAVNEET SINGH (MD)
Entity Type:Individual
Prefix:
First Name:RAVNEET
Middle Name:SINGH
Last Name:RANDHAWA
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:UCONN GRADUATE MEDICAL EDUCATION
Mailing Address - Street 2:263 FARMINGTON AVENUE LM068
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-1921
Mailing Address - Country:US
Mailing Address - Phone:860-679-4763
Mailing Address - Fax:860-679-4624
Practice Address - Street 1:OUTPATIENT CLINIC
Practice Address - Street 2:100 GRAND STREET
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06050
Practice Address - Country:US
Practice Address - Phone:860-224-5261
Practice Address - Fax:860-224-5957
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program