Provider Demographics
NPI:1922449339
Name:MAHAJAN, ANKIT (MD)
Entity Type:Individual
Prefix:
First Name:ANKIT
Middle Name:
Last Name:MAHAJAN
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 1:50 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1979
Mailing Address - Country:US
Mailing Address - Phone:413-748-6484
Mailing Address - Fax:413-748-6486
Practice Address - Street 1:50 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1979
Practice Address - Country:US
Practice Address - Phone:413-748-6484
Practice Address - Fax:413-748-6484
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-13
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT62973207RC0000X
MA1013316207RC0001X, 207RC0000X
DC001636282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No282N00000XHospitalsGeneral Acute Care Hospital