Provider Demographics
NPI:1174522692
Name:JOSHI, VIJAY (MD)
Entity type:Individual
Prefix:
First Name:VIJAY
Middle Name:
Last Name:JOSHI
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:PO BOX 2828
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06011-2828
Mailing Address - Country:US
Mailing Address - Phone:860-585-3906
Mailing Address - Fax:860-585-3907
Practice Address - Street 1:102 NORTH ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4190
Practice Address - Country:US
Practice Address - Phone:860-940-6300
Practice Address - Fax:860-940-6745
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036299207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010036299CT01OtherBLUE CROSS BLUE SHIELD
CTP2882400OtherOXFORD
CT0Q3456OtherHEALTH NET
CTP00092190OtherRAILROAD MEDICARE
CT036299OtherCONNECTICARE
CT3171724OtherAETNA
CT3171726OtherAETNA SPECIALTY
CTH73817Medicare UPIN
CT3171726OtherAETNA SPECIALTY