Provider Demographics
NPI:1174501175
Name:SAKALKALE, DURGADAS P (MD)
Entity type:Individual
Prefix:DR
First Name:DURGADAS
Middle Name:P
Last Name:SAKALKALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3209
Mailing Address - Country:US
Mailing Address - Phone:203-752-3100
Mailing Address - Fax:203-752-9291
Practice Address - Street 1:2200 WHITNEY AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3691
Practice Address - Country:US
Practice Address - Phone:203-752-3100
Practice Address - Fax:203-752-9291
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT430122081P2900X, 2081S0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1174501175Medicaid
CTH84833Medicare UPIN
CT1174501175Medicaid