Provider Demographics
NPI:1306804463
Name:NAWAZ, HAFSA MUSHTAQ (MD)
Entity type:Individual
Prefix:DR
First Name:HAFSA
Middle Name:MUSHTAQ
Last Name:NAWAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1451
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-0551
Mailing Address - Country:US
Mailing Address - Phone:203-691-7401
Mailing Address - Fax:203-935-8955
Practice Address - Street 1:2560 DIXWELL AVE STE 1A
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1852
Practice Address - Country:US
Practice Address - Phone:203-691-7401
Practice Address - Fax:203-935-8955
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044294207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01004439CT01OtherANTHEM BC/BS
CT001442946Medicaid
CT044294OtherCONNECTICARE
CT044294OtherSTATE LICENSE
CT044294OtherSTATE LICENSE
CT001442946Medicaid