Provider Demographics
NPI:1669476016
Name:YEKTA, M HASAN (MD)
Entity Type:Individual
Prefix:
First Name:M
Middle Name:HASAN
Last Name:YEKTA
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 1:27 BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3405
Mailing Address - Country:US
Mailing Address - Phone:860-528-7161
Mailing Address - Fax:860-528-7163
Practice Address - Street 1:27 BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3405
Practice Address - Country:US
Practice Address - Phone:860-528-7161
Practice Address - Fax:860-528-7163
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-10-10
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
CT017642207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD76990Medicare UPIN