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General NPI Number Information
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NPI Number | 1023321148
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Entity Type | Individual
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Provider Name | OMPRAKASH BHASKARA PILLAI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2010
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Last Update Date | 07/18/2010
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Provider Practice Location Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-0001
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Country | US
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Telephone | 860-627-2113
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Fax |
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Provider Business Mailing Address
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Address Line | 17 DEREK LN
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City | WINDSOR
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State | CT
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Zip | 06095-1739
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Country | US
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Telephone | 860-683-0224
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Fax | 860-683-0270
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 035490
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License Number State | CT
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