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NPI Code Detail

MEDICARE: DR. MADHURI PRATINIDHI MD

MEDICARE: DR. MADHURI PRATINIDHI MD
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
1207Q00000XFamily Medicine PhysicianCT035881CT

General Provider Information

NPI Number : 1679590038
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MADHURI PRATINIDHI MD
Provider Business Mailing Address
First Line : 1504 SULLIVAN AVE
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-2711
Country : US
Telephone Number : 860-697-6565
Fax Number : 860-730-4661
Provider Business Practice Location Address
First Line : 1504 SULLIVAN AVE
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-2711
Country : US
Telephone Number : 860-697-6565
Fax Number : 860-731-4661
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 01/20/2026

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Directions to “ DR. MADHURI PRATINIDHI MD” Practice Location

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