Provider Demographics
NPI:1962997940
Name:DOCTORS OFFICE CT PLLC
Entity type:Organization
Organization Name:DOCTORS OFFICE CT PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-325-2120
Mailing Address - Street 1:212 BIBLE ST
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-1322
Mailing Address - Country:US
Mailing Address - Phone:646-652-1791
Mailing Address - Fax:888-981-1828
Practice Address - Street 1:40 E PUTNAM AVE STE 1B
Practice Address - Street 2:
Practice Address - City:COS COB
Practice Address - State:CT
Practice Address - Zip Code:06807-2606
Practice Address - Country:US
Practice Address - Phone:203-489-5442
Practice Address - Fax:203-325-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty