Individual
MIAN HARRIS IFTIKHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
CENTER ON AGING 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-5215
(860) 679-3958
(860) 679-1307
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
(860) 679-3958
(860) 679-1307
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301110511
MI
207R00000X
Internal Medicine Physician
66681
CT
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
066681
CT
Other
Enumeration date
07/05/2016
Last updated
03/12/2024
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