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General NPI Number Information
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NPI Number | 1699967729
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Entity Type | Organization
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Legal Business Name | SHRI KRIS VERMA MD
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 391 OCEAN AVENUE
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City | NEW LONDON
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State | CT
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Zip | 06320-4717
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Country | US
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Telephone | 860-447-2489
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Fax | 860-437-1231
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Provider Business Mailing Address
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Address Line | 391 OCEAN AVENUE
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City | NEW LONDON
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State | CT
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Zip | 06320-4717
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Country | US
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Telephone | 860-447-2489
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Fax | 860-437-1231
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Authorized Official
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Title or Position | MD
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Name | SHRI KRIS VERMA
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Credential | MD
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Telephone | 860-447-2489
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 002911
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 039351
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License Number State | CT
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