Healthcare Provider Details

I. General information

NPI: 1558527382
Provider Name (Legal Business Name): HARSHA V DUVVI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 SILVER ST
MIDDLETOWN CT
06457-3946
US

IV. Provider business mailing address

35 WILLIAM PUCKEY DR
CORTLANDT MANOR NY
10567-6215
US

V. Phone/Fax

Practice location:
  • Phone: 860-346-0300
  • Fax:
Mailing address:
  • Phone: 914-382-6584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number231619
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number64272
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: