Organization
FAIRFIELD COUNTY HEALTH & WELLNESS SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TASNEEM AHMAD KHAN M.D. (PARTNER)
(203) 980-9969
Entity
Organization
Contact information
Practice address
325 REEF RD, SUITE # 109, FAIRFIELD, CT 06824-6537
(203) 955-1822
(203) 955-1823
Mailing address
325 REEF RD, SUITE # 109, FAIRFIELD, CT 06824-6537
(203) 955-1822
(203) 955-1823
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
034005
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001340059
—
CT
Enumeration date
02/03/2014
Last updated
02/03/2014
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