Provider Demographics
NPI:1295094480
Name:DUSHAJ, AZEM (MD)
Entity type:Individual
Prefix:DR
First Name:AZEM
Middle Name:
Last Name:DUSHAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 WHITE PLAINS RD STE 203
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4552
Mailing Address - Country:US
Mailing Address - Phone:203-459-0408
Mailing Address - Fax:203-459-0494
Practice Address - Street 1:888 WHITE PLAINS RD STE 203
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4552
Practice Address - Country:US
Practice Address - Phone:203-459-0408
Practice Address - Fax:203-459-0494
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT65007207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHT400230687OtherMEDICARE
NH3101233Medicaid