Healthcare Provider Details

I. General information

NPI: 1225824394
Provider Name (Legal Business Name): VAHIN MOHANAKRISHNAN M.B.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 MAIN STREET DEPARTMENT OF MEDICAL EDUCATION
BRIDGEPORT CT
06606
US

IV. Provider business mailing address

2800 MAIN STREET DEPARTMENT OF MEDICAL EDUCATION
BRIDGEPORT CT
06606
US

V. Phone/Fax

Practice location:
  • Phone: 475-210-5425
  • Fax: 475-210-5022
Mailing address:
  • Phone: 475-210-5425
  • Fax: 475-210-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: