Provider Demographics
NPI:1215620372
Name:PASSEY, SIDDHANT (MBBS)
Entity type:Individual
Prefix:
First Name:SIDDHANT
Middle Name:
Last Name:PASSEY
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NEWINGTON VA HOSPITAL-VACT PRIMARY CARE
Mailing Address - Street 2:555 WILLARD AVENUE
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111
Mailing Address - Country:US
Mailing Address - Phone:860-808-7921
Mailing Address - Fax:860-667-6875
Practice Address - Street 1:NEWINGTON VA HOSPITAL-VACT PRIMARY CARE
Practice Address - Street 2:555 WILLARD AVENUE
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111
Practice Address - Country:US
Practice Address - Phone:860-808-7921
Practice Address - Fax:860-667-6875
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program