Provider Demographics
NPI:1437131760
Name:ACHARYA, AMI D (MD)
Entity type:Individual
Prefix:DR
First Name:AMI
Middle Name:D
Last Name:ACHARYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2446 WHITNEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:203-248-4461
Mailing Address - Fax:203-248-3932
Practice Address - Street 1:2446 WHITNEY AVENUE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518
Practice Address - Country:US
Practice Address - Phone:203-248-4461
Practice Address - Fax:203-248-3932
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043825207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT160002296OtherMEDICARE ID
CT043825OtherSTATE LICENSE
CT043825OtherSTATE LICENSE