Provider Demographics
NPI:1770576126
Name:PATIL, RANJANA V (MD)
Entity type:Individual
Prefix:DR
First Name:RANJANA
Middle Name:V
Last Name:PATIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RANJANA
Other - Middle Name:MILIND
Other - Last Name:JAVLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 KINGS HWY E
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-4867
Mailing Address - Country:US
Mailing Address - Phone:203-333-0800
Mailing Address - Fax:203-333-0755
Practice Address - Street 1:501 KINGS HWY E
Practice Address - Street 2:SUITE 203
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-4867
Practice Address - Country:US
Practice Address - Phone:203-333-0800
Practice Address - Fax:203-333-0755
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036548208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001365487Medicaid
H35810Medicare UPIN