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General NPI Number Information
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NPI Number | 1013238559
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Entity Type | Individual
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Provider Name | UMU KULTUMI BAH PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 170 MOUNT PLEASANT RD
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City | NEWTOWN
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State | CT
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Zip | 06470
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Country | US
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Telephone | 203-426-1818
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Fax |
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Provider Business Mailing Address
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Address Line | 7 ACADIA LN PH 6404
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City | SHELTON
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State | CT
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Zip | 06484-4466
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Country | US
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Telephone | 240-888-3694
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 017215
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0004200
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 4226
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License Number State | CT
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