Healthcare Provider Details

I. General information

NPI: 1922070853
Provider Name (Legal Business Name): HUMAIRA ASHRAF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/04/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 HARTFORD RD
NEW BRITAIN CT
06053-1526
US

IV. Provider business mailing address

61 KIRKWOOD RD
WEST HARTFORD CT
06117-2832
US

V. Phone/Fax

Practice location:
  • Phone: 860-229-1113
  • Fax:
Mailing address:
  • Phone: 860-231-8216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number041178
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: