Healthcare Provider Details

I. General information

NPI: 1558746289
Provider Name (Legal Business Name): AAKAISH HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LINWOOD AVE
COLCHESTER CT
06415-1138
US

IV. Provider business mailing address

100 LINWOOD AVE
COLCHESTER CT
06415-1138
US

V. Phone/Fax

Practice location:
  • Phone: 860-415-3622
  • Fax: 860-603-2265
Mailing address:
  • Phone: 860-415-3622
  • Fax: 860-603-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SRINIVASULU CONJEEVARAM
Title or Position: PHYSICIAN
Credential: MD
Phone: 630-207-2557