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Contact Information

ITISHA BANSAL
2800 MAIN ST
GME OFFICE
BRIDGEPORT, CT06606
 Phone: 203-576-5425
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for ITISHA BANSAL · (Female)

NPI # 1598185175
Status Active
Credentials
Entity Individual
Enumeration date 04/22/2014
Last updated 09/04/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 291299
Hospital affiliation(s)
  • LITTLE FALLS HOSPITAL - (Critical Access)
    140 BURWELL STREET
    LITTLE FALLS, NY 13365
  • MARY IMOGENE BASSETT HOSPITAL - (Acute Care)
    ONE ATWELL ROAD
    COOPERSTOWN, NY 13326
  • STRONG MEMORIAL HOSPITAL - (Acute Care)
    601 ELMWOOD AVE
    ROCHESTER, NY 14642
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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