Healthcare Provider Details

I. General information

NPI: 1740265925
Provider Name (Legal Business Name): YOGESH KUMAR KATECHIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2005
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 LATHROP AVE
NORWICH CT
06360-2309
US

IV. Provider business mailing address

59 STURGEON RIVER RD
GLASTONBURY CT
06033-2747
US

V. Phone/Fax

Practice location:
  • Phone: 860-204-0883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number035253
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: