Healthcare Provider Details

I. General information

NPI: 1477539872
Provider Name (Legal Business Name): TARALUTA H PARIKH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N MAIN ST
BRISTOL CT
06010-8102
US

IV. Provider business mailing address

85 CICCOLELLA CT
SOUTHINGTON CT
06489-1340
US

V. Phone/Fax

Practice location:
  • Phone: 860-628-8978
  • Fax:
Mailing address:
  • Phone: 860-628-8978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number016442
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: