Individual
DR. ASHA V MANAKTALA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820C PROSPECT HILL ROAD, WINDSOR, CT 06095
(860) 285-8251
(860) 687-1774
Mailing address
345 NORTH MAIN ST, SUITE 248, WEST HARTFORD, CT 06117
(860) 213-8453
(860) 523-4061
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
024267
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010024267CT02
ANTHEM BCBS
CT
01
—
020267
CONNECTICARE
CT
05
—
04058400
—
CT
Enumeration date
03/01/2006
Last updated
07/08/2007
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