Provider Demographics
NPI:1144676032
Name:KAMATH, NITISHA
Entity type:Individual
Prefix:
First Name:NITISHA
Middle Name:
Last Name:KAMATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 RETREAT AVE
Mailing Address - Street 2:HARTFORD HOSPITAL ADULT PRIMARY CARE BROWN STONE
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2527
Mailing Address - Country:US
Mailing Address - Phone:860-972-0200
Mailing Address - Fax:860-545-3149
Practice Address - Street 1:79 RETREAT AVE
Practice Address - Street 2:HARTFORD HOSPITAL ADULT PRIMARY CARE BROWN STONE
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2527
Practice Address - Country:US
Practice Address - Phone:860-972-0200
Practice Address - Fax:860-545-3149
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101266305207R00000X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist