Individual
MOHAMED ALTAF HUSSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
145 UNION STREET, VERNON ROCKVILLE, CT 06066-3025
(860) 375-8440
(860) 858-4091
Mailing address
145 UNION ST, VERNON ROCKVILLE, CT 06066-3025
(860) 375-8440
(860) 858-4091
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5393
CT
363LF0000X
Family Nurse Practitioner
Primary
5393
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008045576
—
CT
05
—
008064264
—
CT
Enumeration date
07/13/2013
Last updated
02/05/2024
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