Healthcare Provider Details

I. General information

NPI: 1326534801
Provider Name (Legal Business Name): AHMED VETEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2018
Last Update Date: 12/11/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PARK ST
NEW HAVEN CT
06519-1110
US

IV. Provider business mailing address

35 PARK ST
NEW HAVEN CT
06519-1110
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-4081
  • Fax: 203-737-7635
Mailing address:
  • Phone: 203-785-4081
  • Fax: 203-737-7635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-15499
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberE-15499
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number76535
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: