Individual
SRIMATHI BALAKRISHNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1162 NEW BRITAIN AVE, W HARTFORD, CT 06110-2410
(860) 236-3084
(860) 561-5961
Mailing address
1162 NEW BRITAIN AVE, W HARTFORD, CT 06110-2410
(860) 236-3084
(860) 561-5961
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
015891
CT
2080A0000X
Pediatric Adolescent Medicine Physician
015891
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001158914
—
CT
01
—
010015891CT01
ANTHEM BLUE SHIELD
CT
01
—
0V3681
HEALTHNET
—
Enumeration date
07/22/2006
Last updated
06/12/2013
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