Individual
DR. QUAZI T ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 MIDDLE TPKE W, MANCHESTER, CT 06040-3816
(860) 533-4176
Mailing address
515 MIDDLE TPKE W, MANCHESTER, CT 06040-3816
(860) 533-4176
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
236846
NY
207Q00000X
Family Medicine Physician
Primary
38371
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236846
DOH
NY
05
—
236846
—
NY
Enumeration date
09/07/2006
Last updated
03/07/2023
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