Basic Information
Provider Information
NPI: 1093179038
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TARASARIA
FirstName: KARAN
MiddleName: N
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 80 SEYMOUR STREET
Address2: HARTFORD HOSPITAL NEUROLOGY DEPT
City: HARTFORD
State: CT
PostalCode: 061028000
CountryCode: US
TelephoneNumber: 8609723621
FaxNumber:  
Practice Location
Address1: 80 SEYMOUR STREET
Address2: HARTFORD HOSPITAL NEUROLOGY DEPT
City: HARTFORD
State: CT
PostalCode: 061028000
CountryCode: US
TelephoneNumber: 8609723621
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2016
LastUpdateDate: 06/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X068833CTN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084V0102X068833CTY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology

No ID Information.


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