Individual
ANANDHI BALESWAREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
481 GOLD STAR HWY, SUITE 100, GROTON, CT 06340-6702
(860) 446-8858
(860) 405-2140
Mailing address
481 GOLD STAR HWY, SUITE 100, GROTON, CT 06340-6702
(860) 446-8858
(860) 405-2140
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
038604
CT
208000000X
Pediatrics Physician
038604
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001386045
—
CT
Enumeration date
06/23/2005
Last updated
11/29/2013
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