Individual
MR. MUIZ ABDUL LATIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
950 CAMPBELL AVE, SURGICAL SERVICE/112, WEST HAVEN, CT 06516-2770
(203) 932-5711
(203) 937-3845
Mailing address
950 CAMPBELL AVE, SURGICAL SERVICE/112, WEST HAVEN, CT 06516-2770
(203) 932-5711
(203) 937-3845
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001648
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001648
PA
CT
Enumeration date
10/02/2006
Last updated
07/08/2007
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