Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 028665 | CT |
NPI | 1023077609 |
---|---|
Provider Name | Prof. Hazar Dahhan |
First Address | Manchester, CT 06042-3540 |
Second Address | Manchester, CT 06042-3540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 02/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001286659 | (05) | CT |
028665 | STATE MEDICAL LICENSE (01) | CT |
A60111 | (02) | CT |