| Radhika Jasthi MD LLC | |
|
80 Mill River St 2200 Stamford CT 06902-3733 | |
| (203) 487-6177 | |
| (203) 487-6178 |
| Full Name | Radhika Jasthi MD LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 80 Mill River St, Stamford, Connecticut |
| Authorized Official Name and Position | Radhika Jasthi (MD) |
| Authorized Official Contact | 2034876177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Radhika Jasthi MD LLC 80 Mill River St 2200 Stamford CT 06902-3733 Ph: (203) 487-6177 | Radhika Jasthi MD LLC 80 Mill River St 2200 Stamford CT 06902-3733 Ph: (203) 487-6177 |
| NPI Number | 1467560086 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 05/30/2017 |
| Medicare PECOS PAC ID | 9436154895 |
|---|---|
| Medicare Enrollment ID | O20060919000359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467560086 | NPI | - | NPPES |
| 001401596 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 040159 (Connecticut) | Primary |
| Provider Name | Radhika Jasthi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457369944 PECOS PAC ID: 3072505049 Enrollment ID: I20040331000519 |
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