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General NPI Number Information
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NPI Number | 1467560086
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Entity Type | Organization
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Legal Business Name | RADHIKA JASTHI MD LLC
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 05/30/2017
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Provider Practice Location Address
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Address Line | 80 MILL RIVER ST 2200
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City | STAMFORD
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State | CT
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Zip | 06902-3733
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Country | US
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Telephone | 203-487-6177
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Fax | 203-487-6178
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Provider Business Mailing Address
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Address Line | 80 MILL RIVER ST 2200
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City | STAMFORD
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State | CT
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Zip | 06902-3733
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Country | US
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Telephone | 203-487-6177
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Fax | 203-487-6178
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Authorized Official
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Title or Position | MD
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Name | RADHIKA JASTHI
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Credential |
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Telephone | 203-487-6177
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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 | 040159
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License Number State | CT
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