MEDICARE: FARHAT ABBAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver	3580	CT

General Provider Information

NPI Number	:	1063054930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARHAT ABBAS

Provider Business Mailing Address
First Line	:	31 SALEM WALK
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-7133
Country	:	US
Telephone Number	:	203-435-6989
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 LOLLER RD
Second Line	:
City	:	HAMDEN
State	:	CT
Zip	:	06514-4315
Country	:	US
Telephone Number	:	203-435-6989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2019
Last Update Date	:	10/11/2019

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Directions to “ FARHAT ABBAS ” Practice Location

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