Provider Demographics
NPI:1871591578
Name:CHHABRA, VIJAY KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:KUMAR
Last Name:CHHABRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 BOSTON POST RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3537
Mailing Address - Country:US
Mailing Address - Phone:203-882-9608
Mailing Address - Fax:
Practice Address - Street 1:849 BOSTON POST RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3537
Practice Address - Country:US
Practice Address - Phone:203-882-9608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041905207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001419052Medicaid
06-1088532OtherTAX ID #
CT004218451Medicaid
CTP00346235Medicare PIN
CTH17227Medicare UPIN
C00633Medicare ID - Type UnspecifiedMR GROUP #
CT001419052Medicaid
CTCD0030Medicare PIN
CTC02798Medicare ID - Type UnspecifiedGROUP NUMBER