Provider Demographics
NPI:1962885368
Name:NAIK, DEEPTHI (MD)
Entity type:Individual
Prefix:DR
First Name:DEEPTHI
Middle Name:
Last Name:NAIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEEPTHI
Other - Middle Name:
Other - Last Name:SHETTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 POST RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6232
Mailing Address - Country:US
Mailing Address - Phone:203-259-7442
Mailing Address - Fax:203-259-5708
Practice Address - Street 1:425 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824
Practice Address - Country:US
Practice Address - Phone:203-259-7442
Practice Address - Fax:203-259-5708
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT61409207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty