Individual
AQSA IJAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
85 LAFAYETTE ST, NEW BRITAIN, CT 06051-1803
(860) 224-3642
(860) 224-2760
Mailing address
19 GRAND ST, MIDDLETOWN, CT 06457-2705
(860) 347-6971
(860) 343-7371
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
83704
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/08/2023
Last updated
03/24/2026
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