MEDICARE: ASEFEH HEIAT M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0901X	Public Health & General Preventive Medicine Physician	041288	CT
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	041288	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033119813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASEFEH HEIAT M.D., M.P.H.

Provider Business Mailing Address
First Line	:	390 LIVINGSTON ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-1336
Country	:	US
Telephone Number	:	203-871-9224
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 LIVINGSTON ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-1336
Country	:	US
Telephone Number	:	203-871-9224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	11/25/2019

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