Healthcare Provider Details

I. General information

NPI: 1588293328
Provider Name (Legal Business Name): AMIAD HAROW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CONNECTICUT AVE
NORWALK CT
06854-1940
US

IV. Provider business mailing address

146 SASAPEQUAN RD
FAIRFIELD CT
06824-7203
US

V. Phone/Fax

Practice location:
  • Phone: 475-330-3369
  • Fax: 475-275-7257
Mailing address:
  • Phone: 475-330-3369
  • Fax: 475-275-7257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number75305
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: