Provider Demographics
NPI:1427140862
Name:AHGHARI, SAEED (MD)
Entity type:Individual
Prefix:DR
First Name:SAEED
Middle Name:
Last Name:AHGHARI
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 1:2928 MAIN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1007
Mailing Address - Country:US
Mailing Address - Phone:860-657-8289
Mailing Address - Fax:860-657-8291
Practice Address - Street 1:677 SILVER LN
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-1257
Practice Address - Country:US
Practice Address - Phone:860-568-7243
Practice Address - Fax:860-895-8107
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030372207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001303726Medicaid
E42324Medicare UPIN
CT001303726Medicaid