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NPI Code Detail

MEDICARE: DR. TAIMUR HABIB M.D.

MEDICARE: DR. TAIMUR HABIB M.D.
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician055653CT

General Provider Information

NPI Number : 1083671861
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAIMUR HABIB M.D.
Provider Business Mailing Address
First Line : C/O NORTHEAST MEDICAL GROUP, INC.
Second Line : 226 MILL HILL AVE., 3RD FLOOR
City : BRIDGEPORT
State : CT
Zip : 06610-2826
Country : US
Telephone Number : 475-319-6035
Fax Number :
Provider Business Practice Location Address
First Line : C/O NORTHEAST MEDICAL GROUP, INC.
Second Line : 226 MILL HILL AVE., 3RD FLOOR
City : BRIDGEPORT
State : CT
Zip : 06610-2826
Country : US
Telephone Number : 475-319-6035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 03/06/2017

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