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General NPI Number Information
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NPI Number | 1700674587
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL MEDICINE ON THE GO, PC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 73 SAND PIT RD STE 204
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City | DANBURY
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State | CT
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Zip | 06810-4015
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Country | US
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Telephone | 203-514-2639
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Fax | 203-514-2659
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Provider Business Mailing Address
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Address Line | 8 QUAIL HOLLOW LN
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City | SANDY HOOK
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State | CT
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Zip | 06482-1284
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Country | US
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Telephone | 203-733-4046
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. IFTIKHAR ALI
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Credential | MD
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Telephone | 203-733-4046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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