Basic Information
Provider Information
NPI: 1942251814
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SARKAR
FirstName: SHIKHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 65 KANE ST
Address2: PROVIDER ENROLLMENT, 2ND FLOOR ADMINISTRATION
City: WEST HARTFORD
State: CT
PostalCode: 061192110
CountryCode: US
TelephoneNumber: 8605236421
FaxNumber: 8605233701
Practice Location
Address1: 263 FARMINGTON AVE
Address2: UCONN MEDICAL GROUP/NEONATOLOGY ASSOCIATES
City: FARMINGTON
State: CT
PostalCode: 060300001
CountryCode: US
TelephoneNumber: 8606793105
FaxNumber: 8606791403
Other Information
ProviderEnumerationDate: 05/15/2006
LastUpdateDate: 09/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080N0001X039561CTY Allopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine

ID Information
IDTypeStateIssuerDescription
139561605CT MEDICAID


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