Healthcare Provider Details

I. General information

NPI: 1124143003
Provider Name (Legal Business Name): NALINI Y MASIH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DISABILITY DETERMINATION SERVICES 309 WAWARME AVE
HARTFORD CT
06114
US

IV. Provider business mailing address

11 ALEXANDER LN
SUFFIELD CT
06078-2429
US

V. Phone/Fax

Practice location:
  • Phone: 860-466-6226
  • Fax:
Mailing address:
  • Phone: 860-466-6226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number45253
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: