Individual
RAJ KUMARI BANSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
226 MILL HILL AVE, 3RD FLOOR, BRIDGEPORT, CT 06610-2811
(203) 384-3873
Mailing address
PO BOX 5246, BRIDGEPORT, CT 06610-0246
(203) 384-3873
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
023303
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001233030
—
CT
Enumeration date
05/02/2006
Last updated
11/03/2014
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