Provider Demographics
NPI:1902874076
Name:SHETH, SAVITA NIRAV (MD)
Entity Type:Individual
Prefix:DR
First Name:SAVITA
Middle Name:NIRAV
Last Name:SHETH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SAVITA
Other - Middle Name:ASHOK KUMAR
Other - Last Name:DUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:71 HAYNES ST
Mailing Address - Street 2:SUITE 1209
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4131
Mailing Address - Country:US
Mailing Address - Phone:860-533-6595
Mailing Address - Fax:860-533-6594
Practice Address - Street 1:71 HAYNES ST
Practice Address - Street 2:SUITE 1209
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4131
Practice Address - Country:US
Practice Address - Phone:860-533-6595
Practice Address - Fax:860-533-6594
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT42000208M00000X
CT042000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2V6239OtherHEALTHNET
CTP3596065OtherOXFORD
CT010042000CT01OtherBC/BS
CT654714OtherCIGNA
CT001420009Medicaid
CT3756455OtherAETNA
CTC003687OtherCHAMPUS
CT00142000900OtherBC/BS FAMILYPLAN
CT042000OtherCONNECTICARE
CTI28387Medicare UPIN
CT3756455OtherAETNA