Provider Demographics
NPI:1245210764
Name:AHMED, SHEIKH IRFAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEIKH
Middle Name:IRFAN
Last Name:AHMED
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 1:580 BURNSIDE AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3579
Mailing Address - Country:US
Mailing Address - Phone:860-528-5068
Mailing Address - Fax:860-528-2341
Practice Address - Street 1:580 BURNSIDE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3579
Practice Address - Country:US
Practice Address - Phone:860-528-5068
Practice Address - Fax:860-528-2341
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033904208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT3390405939OtherCONNECTICARE
CT010033904CT02OtherANTHEM BLUE CROSS
CT0578425018OtherCIGNA
CT182339OtherPREFFERED ONE
CT00133904400OtherBLUE CARE FAMILY PLAN
CT0S0016OtherHEALTH NET
CT1297265OtherUNITED HEALTH CARE
CT5055019OtherAETNA
CT001339044Medicaid
370001734Medicare PIN
CT5055019OtherAETNA
CT001339044Medicaid