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NPI Code Detail

MEDICARE: DR. TAJESH GOHEL

MEDICARE: DR. TAJESH GOHEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry010856CT

General Provider Information

NPI Number : 1518200955
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAJESH GOHEL
Provider Business Mailing Address
First Line : 250 LAMBERTON RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-2129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 250 LAMBERTON RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-2129
Country : US
Telephone Number : 860-688-3663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2013
Last Update Date : 04/04/2013

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