Healthcare Provider Details

I. General information

NPI: 1073874236
Provider Name (Legal Business Name): CMA SUPERIOR HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 HARTFORD RD
NEW BRITAIN CT
06053-1526
US

IV. Provider business mailing address

617 HARTFORD RD
NEW BRITAIN CT
06053-1526
US

V. Phone/Fax

Practice location:
  • Phone: 860-225-6666
  • Fax: 860-229-0843
Mailing address:
  • Phone: 860-225-6666
  • Fax: 860-229-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number042179
License Number StateCT

VIII. Authorized Official

Name: DR. MOHAMMED ALJANABY
Title or Position: DIRECTOR
Credential: M.D
Phone: 860-225-6666