MEDICARE: ANISHA RAJESH PAREKH 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
1	207Q00000X	Family Medicine Physician	039730	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2V0400	OTHER	CT	HEALTHNET PROVIDER ID
2	010039730CT01	OTHER		ANTHEM PROVIDER ID

General Provider Information

NPI Number	:	1538116348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANISHA RAJESH PAREKH M.D.

Provider Business Mailing Address
First Line	:	48 DAISY HILL RD
Second Line	:
City	:	OAKDALE
State	:	CT
Zip	:	06370-1753
Country	:	US
Telephone Number	:	860-442-4909
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 VISTA DR
Second Line	:	EASTPORT NORTH BUSINESS PARK
City	:	OLD LYME
State	:	CT
Zip	:	06371-1537
Country	:	US
Telephone Number	:	860-434-8847
Fax Number	:	860-434-0428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	01/06/2011

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