Provider Demographics
NPI:1891754685
Name:KAPOOR, CHARANJEEV SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:CHARANJEEV
Middle Name:SINGH
Last Name:KAPOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 HAYNES ST FL 2
Mailing Address - Street 2:DEQUATTRO CANCER CENTER
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4113
Mailing Address - Country:US
Mailing Address - Phone:860-646-0670
Mailing Address - Fax:860-643-9388
Practice Address - Street 1:100 HAYNES ST FL 2
Practice Address - Street 2:DEQUATTRO CANCER CENTER
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4113
Practice Address - Country:US
Practice Address - Phone:860-646-0670
Practice Address - Fax:860-643-9388
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042717174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001427170Medicaid
CT83000138Medicare PIN
CTH54923Medicare UPIN