Healthcare Provider Details

I. General information

NPI: 1245231604
Provider Name (Legal Business Name): SATISH KRISHNAMURTHY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MUNSON RD
FARMINGTON CT
06032-2094
US

IV. Provider business mailing address

263 FARMINGTON AVE
FARMINGTON CT
06030-8082
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-6798
  • Fax: 860-679-1430
Mailing address:
  • Phone: 860-679-6798
  • Fax: 860-679-1430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301087790
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number86209
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number218149
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: