DR. SRINIVASULU CONJEEVARAM (NPI# 1780958058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780958058 |
| Entity Type | Individual |
| Full Name | DR. SRINIVASULU CONJEEVARAM |
| Credential | MD |
| Practice Address |
11 Winthrop Rd Apt 2a West Hartford CT 06110-1656 |
| Practice Telephone | 8604153622 |
| Practice Fax Number | 8605401226 |
| Mailing Telephone | 8604153622 |
| Mailing Fax Number | 8605401226 |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2020-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 53644 | CT | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 53644 | CT | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 53644 | CT | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 4301086842 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | STATE MEDICAL LICENSE | 053644 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11 Winthrop Rd, Apt 2a, West Hartford, CT 061101656 | 8604153622 | 8605401226 |
| 146 Main Street, Somers, CT 060711825 | 8604153622 | 8605401226 |
| 421 Cottage Grove Rd Ste B, Bloomfield, CT 060023170 | 8602420034 | 8602423301 |
| Street Address |
11 WINTHROP RD APT 2A |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06110-1656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558746289 | Aakaish Healthcare LLC | General Practice | 11 Winthrop Rd, Apt 2a, West Hartford, CT 06110-1656 | 2015-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306467030 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1500 New Britain Ave, H216, West Hartford, CT 06110 | 2020-05-05 |
| 1962903492 | Mitchell Graham | Chiropractor | 121 Talcott Rd, West Hartford, CT 06110 | 2018-02-21 |
| 1417302829 | Kaitlyn Roggi | Behavioral Analyst | 101 South St Fl 2, West Hartford, CT 06110 | 2016-05-04 |
| 1487036802 | Nino Gigauri | Internal Medicine | 114 Woodlawn St, Hartford, CT 06110 | 2015-06-22 |
| 1093082174 | Shital Makati | Pharmacist | 940 South Quaker Lane, West Hartford, CT 06110 | 2011-11-17 |
| 1376842948 | Kenneth Reeve | Pediatrics | 1459a New Britain Ave, West Hartford, CT 06110 | 2011-03-22 |
| 1225368913 | Jenny Alzate Lpc LLC | Counselor | 78 Cambridge St, West Hartford, CT 06110 | 2010-01-04 |
| 1821200957 | Advocate Community Care Agency, Inc. | Home Delivered Meals | 1086 New Britain Ave, West Hartford, CT 06110 | 2007-05-03 |
| 1730257155 | Catherine Ann Staunton | Physical Therapist | 1350 Chapel Street, New Haven, CT 06110 | 2006-12-01 |
| 1689750002 | Pamela M Matuszewski | Optometrist | 1445 New Britain Ave, W Hartford, CT 06110 | 2006-10-27 |
| Find all providers in zip 06110 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386892354 | Jonathan Bruce Stolzenberg | General Practice | 32 Arlington Rd, West Hartford, CT 06107-1603 | 2008-09-03 |
| 1558746289 | Aakaish Healthcare LLC | General Practice | 11 Winthrop Rd, Apt 2a, West Hartford, CT 06110-1656 | 2015-07-23 |
| 1346449386 | Ronald T. Suski | General Practice | 11 Oxford Dr, West Hartford, CT 06107-1622 | 2007-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669029773 | Medexpress Primary Care Texas, P.a. | General Practice | 185 Asylum Street, City Place 1, Hartford, CT 06103-3408 | 2019-08-22 |
| 1225510571 | David Warren Boxwell | General Practice | 67 Church St., Suite 300, Norwich, CT 06360-0636 | 2018-09-04 |
| 1407234685 | Adrian Kenneth Wyllie | General Practice | 4 Research Pkwy, Wallingford, CT 06492-1929 | 2015-05-08 |
| 1740612829 | Stanley Brovender | General Practice | 773b Pontiac Lane, Stratford, CT 06614 | 2013-07-31 |
| 1528300191 | Theodore Herbert Johnson | General Practice | 141 S Mountain Dr, New Britain, CT 06052-1511 | 2013-03-21 |
| 1811237142 | Jose Buhain | General Practice | 19 Judson Ave Apt 5d, Woodbury, CT 06798-2844 | 2013-02-23 |
| 1548520661 | Cynthia Zywocinski | General Practice | 92 Everit St, New Haven, CT 06511-1321 | 2012-05-23 |
| 1093071631 | Roger Joseph Branson | General Practice | 12 Woodcreek Rd, Bethlehem, CT 06751-1705 | 2012-04-09 |
| 1427323401 | Kevin David Wolter | General Practice | 43 Oxford Ct, Mystic, CT 06355-1705 | 2012-03-09 |
| 1144590191 | Richard John Annulli | General Practice | 1037 Valley Rd, New Canaan, CT 06840-2818 | 2012-01-09 |
| Find all providers with the same taxonomy | ||||
| City | WEST HARTFORD |
| Zip Code | 06110 |
Please comment or provide details below to improve the information on DR. SRINIVASULU CONJEEVARAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.