Healthcare Provider Details

I. General information

NPI: 1942530977
Provider Name (Legal Business Name): IFTIKHAR ALI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 SAND PIT RD STE 204
DANBURY CT
06810-4015
US

IV. Provider business mailing address

8 QUAIL HOLLOW LN
SANDY HOOK CT
06482-1284
US

V. Phone/Fax

Practice location:
  • Phone: 203-514-2639
  • Fax: 203-514-2659
Mailing address:
  • Phone: 203-733-4046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number047019
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number047019
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: