Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 55416 | CT |
Y | 111NI0900X | Internist | 55416 | CT |
N | 207RA0401X | Internist - Addiction Medicine | 55416 | CT |
N | 207RG0100X | Gastroenterologist | 55416 | CT |
NPI | 1609211622 |
---|---|
Provider Name | Dr. Lamia Haque |
First Address | New Haven, CT 06510-3206 |
Second Address | New Haven, CT 06510-3220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2013 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008066801 | LAMIA MEDICAID (01) | CT |