Provider Demographics
NPI:1619073210
Name:AHASIC, AMY MARIE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:AHASIC
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:789 HOWARD AVE
Mailing Address - Street 2:WINCHESTER CHEST CLINIC
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1304
Mailing Address - Country:US
Mailing Address - Phone:203-785-4198
Mailing Address - Fax:203-737-5453
Practice Address - Street 1:789 HOWARD AVE
Practice Address - Street 2:WINCHESTER CHEST CLINIC
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1304
Practice Address - Country:US
Practice Address - Phone:203-785-4198
Practice Address - Fax:203-737-5453
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA222401207R00000X, 207RP1001X, 207RC0200X, 2083P0500X
CT41354207RC0200X, 207RP1001X, 207R00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine