Provider Demographics
NPI:1427071570
Name:RAMANAN, CHITRALAKA (MD)
Entity type:Individual
Prefix:
First Name:CHITRALAKA
Middle Name:
Last Name:RAMANAN
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 1:1162 NEW BRITAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-2410
Mailing Address - Country:US
Mailing Address - Phone:860-236-3084
Mailing Address - Fax:860-561-5961
Practice Address - Street 1:1162 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2410
Practice Address - Country:US
Practice Address - Phone:860-236-3084
Practice Address - Fax:860-561-5961
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018086208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
0V3647OtherHEALTHNET
CT010018086CT01OtherANTHEM BLUE SHIELD
CT001180868Medicaid
CTG21660Medicare UPIN
CT370001231Medicare ID - Type Unspecified