Healthcare Provider Details

I. General information

NPI: 1275155939
Provider Name (Legal Business Name): PRUTHWY RAM ADDANKI MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORWALK HOSPITAL, PART OF NUVANCE HEALTH 34 MAPLE STREET
NORWALK CT
06850
US

IV. Provider business mailing address

NORWALK HOSPITAL, PART OF NUVANCE HEALTH 34 MAPLE STREET
NORWALK CT
06850
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-2000
  • Fax: 860-714-8275
Mailing address:
  • Phone: 203-852-2000
  • Fax: 860-679-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: