Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 030847 | CT |
Y | 2084N0402X | Child Neurologist | 030847 | CT |
NPI | 1114980968 |
---|---|
Provider Name | Alok Bhargava |
First Address | Waterbury, CT 06708-2507 |
Second Address | Waterbury, CT 06708-2507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 30/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001308479 | (05) | CT |
010030847CT01 | BLUE CROSS & BLUE SHIELD (01) | CT |
030847 | CONNECTICARE (01) | CT |
E57916 | (02) | CT |