Doctor Name: | AARTHI KANNAN |
NPI Number: | 1093197634 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.B.B.S. |
License Number: | |
Business Practice Address: | 79 Retreat Avenue Hartford Hospital Adult Primary Care - Brown Stone Hartford, CT - 06102 |
Business Phone Number: | 8605450200 |
Business Fax Number: | 8605453149 |
Mailing Address: | 79 Retreat Avenue, Hartford Hospital Adult Primary Care - Brown Stone HARTFORD |
State: | CT |
Postal Code: | 06102 |
Phone Number: | 8605450200 |
Fax Number: | 8605453149 |
NPI Enumeration Date: | 06/19/2015 |
NPI Last Update Date: | 06/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 01/25/2016 |
NPI Reactivation Date: | 05/25/2016 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |