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NPI Code Detail

MEDICARE: MISBAH M VAHIDY M.D.

MEDICARE:   MISBAH M VAHIDY  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
1207Q00000XFamily Medicine Physician019550CT
2208600000XSurgery Physician19550CT

General Provider Information

NPI Number : 1164461091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISBAH M VAHIDY M.D.
Provider Business Mailing Address
First Line : 677 SILVER LN
Second Line :
City : EAST HARTFORD
State : CT
Zip : 06118-1257
Country : US
Telephone Number : 860-569-7399
Fax Number : 860-895-8107
Provider Business Practice Location Address
First Line : 677 SILVER LN
Second Line :
City : EAST HARTFORD
State : CT
Zip : 06118-1257
Country : US
Telephone Number : 860-568-7243
Fax Number : 860-895-8107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 10/16/2019

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Directions to “ MISBAH M VAHIDY M.D.” Practice Location

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