Organization
CENTRAL CONNECTICUT NEUROSURGERY AND SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED M KHAN MD (OWNER / PHYSICIAN)
(860) 225-1227
Entity
Organization
Contact information
Practice address
1 LIBERTY SQ FL 1, NEW BRITAIN, CT 06051-2637
(860) 225-1227
(860) 225-1253
Mailing address
1 LIBERTY SQ FL 1, NEW BRITAIN, CT 06051-2637
(860) 225-1227
(860) 225-1253
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
039336
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO3839
MEDICARE PTAN
CT
Enumeration date
11/26/2007
Last updated
05/29/2019
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