Tkeshelashvili, David
Tkeshelashvili, David is an sole proprietor health care provider with primary practice located at 60 Westwood Ave Suite320, Waterbury CT 06708-2460. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Tkeshelashvili, David can be contacted via phone (203) 756-8995.Contact Information
Primary practice address
60 Westwood Ave Suite320
Waterbury CT 06708-2460
Phone: (203) 756-8995
Fax: (203) 756-4041
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 036113 | Connecticut |
Profile Details
| NPI number | 1306878731 |
|---|---|
| LBN Legal business name | Tkeshelashvili, David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306878731 | NPPES |
| Connecticut | MEDICAID | 1361138 |
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