Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 258654-1 | NY |
Y | 2080P0210X | Pediatric Nephrologist | 53408 | CT |
NPI | 1487921664 |
---|---|
Provider Name | Samriti Dogra |
First Address | Hartford, CT 06106-3322 |
Second Address | Hartford, CT 06106-3322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2011 |
Last Update Date | 10/08/2014 |