Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 048300 | CT |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 048300 | CT |
NPI | 1336329465 |
---|---|
Provider Name | Sowmya S Kurtakoti |
First Address | Hartford, CT 06112-2132 |
Second Address | Hartford, CT 06112-2132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2007 |
Last Update Date | 18/02/2011 |