Provider Demographics
NPI:1396591475
Name:SHET, VALLABH NAGARAJ (MBBS)
Entity type:Individual
Prefix:
First Name:VALLABH
Middle Name:NAGARAJ
Last Name:SHET
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND STREET
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052
Mailing Address - Country:US
Mailing Address - Phone:860-224-5261
Mailing Address - Fax:860-224-5957
Practice Address - Street 1:100 GRAND STREET, OUTPATIENT CLINIC, THE HOSPITAL OF CE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052
Practice Address - Country:US
Practice Address - Phone:860-224-5261
Practice Address - Fax:860-224-5957
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2025-02-03
Deactivation Date:2024-12-31
Deactivation Code:
Reactivation Date:2025-01-31
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program