Individual
KAMRAN KIZILBASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
409 MAPLE AVENUE-D2N, HARTFORD, CT 06106
(860) 545-7062
(860) 545-7920
Mailing address
200 RETREAT AVE, HARTFORD, CT 06106-3309
(860) 545-7062
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
41695
CT
Other
Enumeration date
05/19/2023
Last updated
08/02/2023
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