Healthcare Provider Details

I. General information

NPI: 1841309192
Provider Name (Legal Business Name): SAIMA J ANSARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 NAEK RD STE 2
VERNON CT
06066-3965
US

IV. Provider business mailing address

79 WAWECUS ST SUITE 102
NORWICH CT
06360-2160
US

V. Phone/Fax

Practice location:
  • Phone: 860-875-2444
  • Fax: 860-872-2936
Mailing address:
  • Phone: 860-204-9735
  • Fax: 860-204-9793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number046328
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number046328
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: