Individual
QAIYUM MUJTABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 SAVIN AVE, WEST HAVEN, CT 06516-4314
(203) 931-7710
Mailing address
381 TIMBERLANE DR, ORANGE, CT 06477-2844
(203) 931-7710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16546
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1165463
—
CT
Enumeration date
01/03/2006
Last updated
11/02/2020
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