Provider Demographics
NPI:1316523582
Name:WINDSOR PSYCHIATRIC SERVICES, PLLC
Entity type:Organization
Organization Name:WINDSOR PSYCHIATRIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MAHBOOB
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:ASLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-969-1101
Mailing Address - Street 1:88 DAY HILL RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-2200
Mailing Address - Country:US
Mailing Address - Phone:959-255-8080
Mailing Address - Fax:959-255-8081
Practice Address - Street 1:88 DAY HILL RD STE 104
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2200
Practice Address - Country:US
Practice Address - Phone:959-255-8080
Practice Address - Fax:959-255-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT047643OtherCT LICENSE NUMBER