Provider Demographics
NPI:1437361870
Name:THAKKAR, VATSAL G (MD)
Entity type:Individual
Prefix:DR
First Name:VATSAL
Middle Name:G
Last Name:THAKKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1720 POST RD E
Mailing Address - Street 2:SUITE 223
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5643
Mailing Address - Country:US
Mailing Address - Phone:203-220-6390
Mailing Address - Fax:203-220-6384
Practice Address - Street 1:1720 POST RD E
Practice Address - Street 2:SUITE 223
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5643
Practice Address - Country:US
Practice Address - Phone:203-220-6390
Practice Address - Fax:203-220-6384
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-2382102084P0800X
CT499322084P0800X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H60491Medicare UPIN