Healthcare Provider Details

I. General information

NPI: 1972577518
Provider Name (Legal Business Name): YASMINE S KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YASMINE SAYED MD

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 HARTFORD TPKE SUITE A
VERNON CT
06066-4845
US

IV. Provider business mailing address

460 HARTFORD TPKE SUITE A
VERNON CT
06066-4845
US

V. Phone/Fax

Practice location:
  • Phone: 860-896-4877
  • Fax: 860-896-4876
Mailing address:
  • Phone: 860-896-4877
  • Fax: 860-896-4876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number040869
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: