Provider Demographics
NPI:1104048610
Name:SACHETI, BHAVNA (MD)
Entity type:Individual
Prefix:
First Name:BHAVNA
Middle Name:
Last Name:SACHETI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 ELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2715
Mailing Address - Country:US
Mailing Address - Phone:860-644-1533
Mailing Address - Fax:860-644-1252
Practice Address - Street 1:1728 ELLINGTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2715
Practice Address - Country:US
Practice Address - Phone:860-644-1533
Practice Address - Fax:860-644-1252
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048990208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics