Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 55978 | CT |
NPI | 1013169671 |
---|---|
Provider Name | Dr. Sri Smitha Kanaparthy |
First Address | New Haven, CT 06510-3206 |
Second Address | New Haven, CT 06510-3206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2008 |
Last Update Date | 04/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
28853 | OKLAHOMA MEDICAL LICENSE (01) | OK |
55978 | CT MEDICAL LICENSE (01) | CT |
MT 193310 | COMMONWEALTH OF PENNSYLVANIA (01) | PA |