Provider Demographics
NPI:1720139843
Name:BABU, LAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:
Last Name:BABU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2573
Mailing Address - Country:US
Mailing Address - Phone:860-284-5200
Mailing Address - Fax:
Practice Address - Street 1:10 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:CT
Practice Address - Zip Code:06085
Practice Address - Country:US
Practice Address - Phone:860-675-1445
Practice Address - Fax:860-675-1447
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400024547Medicare PIN