Individual
DR. MAYANKA TICKOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.S.
Contact information
Practice address
300 CEDAR ST FL 4, NEW HAVEN, CT 06519
(203) 737-1240
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 737-1240
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
60511
CT
207RP1001X
Pulmonary Disease Physician
Primary
265375
MA
207RP1001X
Pulmonary Disease Physician
60511
CT
Other
Enumeration date
07/03/2012
Last updated
05/12/2018
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