Provider Demographics
NPI:1205077146
Name:WAQAR, SADAF (DO)
Entity type:Individual
Prefix:DR
First Name:SADAF
Middle Name:
Last Name:WAQAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WEST AVON ROAD
Mailing Address - Street 2:SUITE E
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-4275
Mailing Address - Country:US
Mailing Address - Phone:860-674-9900
Mailing Address - Fax:860-678-0036
Practice Address - Street 1:30 WEST AVON ROAD
Practice Address - Street 2:SUITE E
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-4275
Practice Address - Country:US
Practice Address - Phone:860-674-9900
Practice Address - Fax:860-678-0036
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-22
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10136207N00000X, 207R00000X
CT53002207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine