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NPI Code Detail

MEDICARE: DR. ISHANI RAY-DATTA M.D.

MEDICARE: DR. ISHANI RAY-DATTA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician033467CT

General Provider Information

NPI Number : 1447306600
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ISHANI RAY-DATTA M.D.
Provider Business Mailing Address
First Line : 46 DELAFIELD ISLAND RD
Second Line :
City : DARIEN
State : CT
Zip : 06820-6010
Country : US
Telephone Number : 203-656-3130
Fax Number :
Provider Business Practice Location Address
First Line : 26 PALMERS HILL RD
Second Line :
City : STAMFORD
State : CT
Zip : 06902-2113
Country : US
Telephone Number : 203-656-3130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2007
Last Update Date : 07/08/2007

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