Provider Demographics
NPI:1740265925
Name:KATECHIA, YOGESH KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:YOGESH
Middle Name:KUMAR
Last Name:KATECHIA
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 1:59 STURGEON RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2747
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 LATHROP AVE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2309
Practice Address - Country:US
Practice Address - Phone:860-204-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-11
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035253207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001352533Medicaid
CTG36647Medicare UPIN
CT080001547Medicare ID - Type Unspecified