Provider Demographics
NPI:1396155396
Name:GILL, KUDRAT (MD)
Entity type:Individual
Prefix:
First Name:KUDRAT
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:101 N PLAINS INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2360
Mailing Address - Country:US
Mailing Address - Phone:203-949-2700
Mailing Address - Fax:203-949-4271
Practice Address - Street 1:435 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2101
Practice Address - Country:US
Practice Address - Phone:203-949-2700
Practice Address - Fax:203-949-2712
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2020-06-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT649572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology