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Individual

MR. MUBARIK N MIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
428 BROAD ST, MERIDEN, CT 06450-5846
(203) 235-6527
Mailing address
101 ARCH ST # 1, MERIDEN, CT 06450-4317
(203) 235-6527
(203) 440-4438

Taxonomy

Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
1226
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1226
TAXI
CT
05
1226
CT
Enumeration date
08/29/2018
Last updated
08/29/2018
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