Provider Demographics
NPI:1215913793
Name:PANDIT, RANJIT S (MD)
Entity type:Individual
Prefix:
First Name:RANJIT
Middle Name:S
Last Name:PANDIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 DEL PRADO DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-2333
Mailing Address - Country:US
Mailing Address - Phone:860-589-6191
Mailing Address - Fax:
Practice Address - Street 1:10 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-8102
Practice Address - Country:US
Practice Address - Phone:860-589-5230
Practice Address - Fax:860-589-5297
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021624208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E58168Medicare UPIN