Individual
SANJEEV RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
968 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 330-6000
(203) 382-9425
Mailing address
75 STONE RIDGE WAY, APT # 1E, FAIRFIELD, CT 06824-5385
(203) 366-4000
(203) 382-2954
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
039893
CT
207R00000X
Internal Medicine Physician
039893
CT
208000000X
Pediatrics Physician
039893
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236130
—
CT
Enumeration date
07/17/2006
Last updated
01/18/2012
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