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General NPI Number Information
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NPI Number | 1275108938
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Entity Type | Individual
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Provider Name | GARIMA GAUTAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 100 GRAND STREET HOSPITAL OF CENTRAL CONNECICUT
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City | NEW BRITAIN
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State | CT
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Zip | 06052
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Country | US
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Telephone | 959-595-1751
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Fax | 860-266-5785
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Provider Business Mailing Address
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Address Line | 1290 SILAS DEANE HIGHWAY CREDENTIALING VERIFICATION ORGANIZATION, HARTFORD HEALT
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City | WETHERSFIELD
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State | CT
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Zip | 06109
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Country | US
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Telephone | 202-449-0827
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Fax | 860-972-7040
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 76442
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License Number State | CT
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