Provider Demographics
NPI:1982724852
Name:PHANSALKAR, SACHIN SHAMKANT (MD)
Entity Type:Individual
Prefix:
First Name:SACHIN
Middle Name:SHAMKANT
Last Name:PHANSALKAR
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 1:5 VILLAGE WAY
Mailing Address - Street 2:UNIT E
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-2050
Mailing Address - Country:US
Mailing Address - Phone:508-455-0681
Mailing Address - Fax:
Practice Address - Street 1:60 HODGES AVE
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3034
Practice Address - Country:US
Practice Address - Phone:508-977-3136
Practice Address - Fax:508-977-3208
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2103302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry