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General NPI Number Information
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NPI Number | 1245210764
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Entity Type | Individual
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Provider Name | SHEIKH IRFAN AHMED M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 07/24/2009
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Provider Practice Location Address
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Address Line | 580 BURNSIDE AVE SUITE 4
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City | EAST HARTFORD
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State | CT
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Zip | 06108-3579
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Country | US
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Telephone | 860-528-5068
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Fax | 860-528-2341
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Provider Business Mailing Address
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Address Line | 580 BURNSIDE AVE SUITE 4
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City | EAST HARTFORD
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State | CT
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Zip | 06108-3579
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Country | US
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Telephone | 860-528-5068
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Fax | 860-528-2341
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 033904
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License Number State | CT
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