Provider Demographics
NPI:1982267472
Name:JAGGERNAUTH, NIKITA SARIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIKITA
Middle Name:SARIKA
Last Name:JAGGERNAUTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:NORWALK HOSPITAL
Mailing Address - Street 2:34 MAPLE STREET
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06856-3815
Mailing Address - Country:US
Mailing Address - Phone:203-852-2025
Mailing Address - Fax:203-899-5224
Practice Address - Street 1:NORWALK HOSPITAL
Practice Address - Street 2:34 MAPLE STREET
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06856-3815
Practice Address - Country:US
Practice Address - Phone:203-852-2025
Practice Address - Fax:203-899-5224
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT71151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program