National Provider Identifier Database

MIRJANA J DOMAKONDA, MD – NPI #1275853178
Child & Adolescent Psychiatry

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.


Contact Information

MIRJANA J DOMAKONDA, MD
200 RETREAT AVE
HARTFORD, CT06106-3309
Phone: 860-545-7493
Fax:
Website:
Specialty Taxonomy Code
* Child & Adolescent Psychiatry 2084P0804X
Psychiatry 2084P0800X

* Indicates primary specialty

NPI Profile & details for MIRJANA J DOMAKONDA

NPI Number 1275853178
Credentials MD
Entity Individual
Enumeration date 06/03/2010
Last updated 09/09/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • CT License #: 055758
  • MA License #: 244741
  • CT Medicaid: 1275853178
Hospital affiliation n/a

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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