1194571000 NPI number — MR. MUHAMMAD MUSTAFA KAMAL MBBS

Table of content: MR. MUHAMMAD MUSTAFA KAMAL MBBS (NPI 1194571000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194571000 NPI number — MR. MUHAMMAD MUSTAFA KAMAL MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAMAL
Provider First Name:
MUHAMMAD
Provider Middle Name:
MUSTAFA
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MBBS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194571000
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
12/31/2024
NPI Reactivation Date:
01/27/2025

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 GRAND STREET, OUTPATIENT CLINIC, THE HOSPITAL OF CO
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BRITAIN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-224-5261
Provider Business Mailing Address Fax Number:
680-224-5957

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 GRAND STREET, OUTPATIENT CLINIC, THE HOSPITAL OF CO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BRITAIN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-224-5261
Provider Business Practice Location Address Fax Number:
680-224-5957
Provider Enumeration Date:
04/30/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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