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General NPI Number Information
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NPI Number | 1912278961
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF CONNECTICUT
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 24 PARK PL APT# 14K
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City | HARTFORD
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State | CT
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Zip | 06106-5008
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Country | US
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Telephone | 860-967-5060
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Fax |
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Provider Business Mailing Address
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Address Line | 24 PARK PL APT# 14K
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City | HARTFORD
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State | CT
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Zip | 06106-5008
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Country | US
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Telephone | 860-967-5060
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | MS. UMMERUBAB SYEDA
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Credential | MD
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Telephone | 860-967-5060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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