Healthcare Provider Details

I. General information

NPI: 1023045184
Provider Name (Legal Business Name): YASSER A AL-BAGHDADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST ANESTHESIA DEPT
HARTFORD CT
06106-3315
US

IV. Provider business mailing address

99 E RIVER DR 5TH FLOOR
EAST HARTFORD CT
06108-3288
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-2117
  • Fax: 860-545-1784
Mailing address:
  • Phone: 860-282-4083
  • Fax: 860-289-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number038329
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number38329
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number246473-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number4301079793
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number38329
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number038329
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: