Healthcare Provider Details

I. General information

NPI: 1942407853
Provider Name (Legal Business Name): TALHAT AZEMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 02/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST 821
HARTFORD CT
06106-5527
US

IV. Provider business mailing address

85 RIBERA LN
MIDDLETOWN CT
06457-5594
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-5061
  • Fax:
Mailing address:
  • Phone: 860-343-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number045859
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: