Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 60868 | CT |
NPI | 1023301835 |
---|---|
Provider Name | Ayyaz A Ali |
First Address | Hartford, CT 06106-5528 |
Second Address | Hartford, CT 06106-5528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2011 |
Last Update Date | 12/03/2020 |