Healthcare Provider Details

I. General information

NPI: 1669424669
Provider Name (Legal Business Name): ABHAY J DHOND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 12/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 CHAPEL ST.
NEW HAVEN CT
06511-4405
US

IV. Provider business mailing address

226 MILL HILL AVE 3RD FLOOR
BRIDGEPORT CT
06610-2826
US

V. Phone/Fax

Practice location:
  • Phone: 203-789-4044
  • Fax: 203-789-3007
Mailing address:
  • Phone: 203-789-4044
  • Fax: 203-789-3007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD072977L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number039393
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD-072977L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number039393
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: