Individual
DR. ALEXIS GOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 QUAKER FARMS RD STE 1, SOUTHBURY, CT 06488-2732
(203) 262-9300
(855) 719-2198
Mailing address
67 MAPLE AVE, DERBY, CT 06418-1328
(203) 732-1330
(203) 732-1332
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
034613
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034613
STATE MEDICAL LICENSE
CT
Enumeration date
08/10/2012
Last updated
10/30/2018
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