Provider Demographics
NPI:1831206457
Name:RAO, KESHAV R (MD)
Entity type:Individual
Prefix:
First Name:KESHAV
Middle Name:R
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1000 ASYLUM AVE
Mailing Address - Street 2:STE 4304
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105
Mailing Address - Country:US
Mailing Address - Phone:860-522-3711
Mailing Address - Fax:860-493-1885
Practice Address - Street 1:1000 ASYLUM AVE
Practice Address - Street 2:STE 4304
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105
Practice Address - Country:US
Practice Address - Phone:860-522-3711
Practice Address - Fax:860-493-1885
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2016-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0248892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001248897Medicaid
CT001248897Medicaid
D02508Medicare UPIN