1417029877 NPI number — DR. RAVINDER K. ALAIGH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417029877 NPI number — DR. RAVINDER K. ALAIGH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALAIGH
Provider First Name:
RAVINDER
Provider Middle Name:
K.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALAIGH
Provider Other First Name:
RAVINDER
Provider Other Middle Name:
K.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1417029877
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
90 MORGAN ST
Provider Second Line Business Mailing Address:
SUITE # 103
Provider Business Mailing Address City Name:
STAMFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06905-5466
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-325-2120
Provider Business Mailing Address Fax Number:
203-325-3270

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 MORGAN ST
Provider Second Line Business Practice Location Address:
SUITE # 103
Provider Business Practice Location Address City Name:
STAMFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06905-5466
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-325-2120
Provider Business Practice Location Address Fax Number:
203-325-3270
Provider Enumeration Date:
11/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  034325 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GROUP # 004142337 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001343251 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




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