Provider Demographics
NPI:1669412961
Name:DAFTARY, ADITYA R (MD)
Entity type:Individual
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First Name:ADITYA
Middle Name:R
Last Name:DAFTARY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:205 CHURCH STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-1805
Mailing Address - Country:US
Mailing Address - Phone:203-773-0427
Mailing Address - Fax:775-242-2409
Practice Address - Street 1:205 CHURCH STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-1805
Practice Address - Country:US
Practice Address - Phone:203-773-0427
Practice Address - Fax:775-242-2409
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT405842085N0904X, 2085R0202X
GA0572962085N0904X, 2085R0202X
IL361150132085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology