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General NPI Number Information
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NPI Number | 1942828926
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Entity Type | Individual
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Provider Name | SURABHI KHASGIWALA MD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 09/04/2023
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Provider Practice Location Address
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Address Line | 282 WASHINGTON ST
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City | HARTFORD
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State | CT
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Zip | 06106-3322
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Country | US
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Telephone | 860-837-5184
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Fax |
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Provider Business Mailing Address
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Address Line | 304 COLT HWY APT 31
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City | FARMINGTON
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State | CT
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Zip | 06032-3075
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Country | US
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Telephone | 585-729-9997
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD-23607
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MDR-7998
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 1.074432-RES
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License Number State | CT
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