DEEPTHI KODALI (NPI# 1750738860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750738860 |
Entity Type | Individual |
Full Name | DEEPTHI KODALI |
Credential | M.D. |
Practice Address |
131 Coventry Street Burgdorf Clinic Burgdorf / Fleet Medical Center Hartford CT 06112 |
Practice Telephone | 8607142813 |
Practice Fax Number | 8607148541 |
Mailing Telephone | 8607142813 |
Mailing Fax Number | 8607148541 |
Enumeration Date | 2016-05-18 |
Last Update Date | 2016-08-04 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
131 COVENTRY STREET BURGDORF CLINIC BURGDORF / FLEET MEDICAL CENTER |
City | HARTFORD |
State | CT |
Zip Code | 06112 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063410389 | Burgdorf Pharmacy Inc | Pharmacy | 131 Coventry Street, 2nd Fl, Hartford, CT 06112 | 2005-07-11 |
1538693833 | Shaina Rodrigues | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, Burgdorf Clinic, Hartford, CT 06112 | 2017-04-13 |
1033566716 | Lakshmi Kavitha Kalluri | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, Burgdorf/fleet Medical Centre, Hartford, CT 06112 | 2016-05-23 |
1023427911 | Amarpreet Sanghera | Internal Medicine | 131 Coventry Street, Burgdorf/fleet Medical Center, Hartford, CT 06112 | 2014-08-05 |
1811199979 | Burgdorf Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 131 Coventry Street, 2nd Fl, Hartford, CT 06112 | 2007-06-01 |
1891705315 | Anne H Flitcraft | Neuromusculoskeletal Medicine & OMM | 131 Coventry Street, Burgdorf Clinic 2nd Floor - Administration, Hartford, CT 06112 | 2006-08-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
Find all providers in zip 06112 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750907325 | Vartika Kesarwani | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-19 |
1720602865 | Meher Kaur Singha | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2020-06-04 |
1275155939 | Pruthwy R Addanki | Student in an Organized Health Care Education/Training Program | Saint Francis Clinic, 1000 Asylum Avenue, Suite 1004, Hartford, CT 06105 | 2020-05-15 |
1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
1669009916 | Amjad O. M. Saad | Student in an Organized Health Care Education/Training Program | 80 Seymour St # 6102, Hartford, CT 06102-8000 | 2020-03-26 |
1497317986 | Muhammad Akrmah | Student in an Organized Health Care Education/Training Program | 250 Main St Apt 431, Hartford, CT 06106-1871 | 2019-07-03 |
1700447802 | Samuel Flynn | Student in an Organized Health Care Education/Training Program | 1000 Asylum Avenue, Suite 3200, Hartford, CT 06105 | 2019-06-28 |
1497314140 | Eduardo Mantovani Cardoso | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-06-06 |
1518523059 | Krishna Patel | Student in an Organized Health Care Education/Training Program | 86 Seymour St, Hartford, CT 06106-2441 | 2019-05-09 |
1114582178 | Dimitrios Drekolias | Student in an Organized Health Care Education/Training Program | Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 | 2019-05-06 |
Find all providers in HARTFORD |
Please comment or provide details below to improve the information on DEEPTHI KODALI.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.