Provider Demographics
NPI:1972185643
Name:LINGIAH, KRISHNA ANAND (DO)
Entity type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:ANAND
Last Name:LINGIAH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:71 HAYNES ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4131
Mailing Address - Country:US
Mailing Address - Phone:860-533-4679
Mailing Address - Fax:860-645-4151
Practice Address - Street 1:2080 SILAS DEANE HWY STE 301
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2334
Practice Address - Country:US
Practice Address - Phone:860-529-5507
Practice Address - Fax:860-529-5644
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CT79604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program