MEDICARE: DR. AMAR M ALKHOTANI MD

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1407378243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMAR M ALKHOTANI MD

Provider Business Mailing Address
First Line	:	120 MAIN ST FL 3
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-7834
Country	:	US
Telephone Number	:	203-743-0100
Fax Number	:	203-300-5176

Provider Business Practice Location Address
First Line	:	57 NORTH ST STE 311
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-5628
Country	:	US
Telephone Number	:	203-743-0100
Fax Number	:

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

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	07/13/2017

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