Provider Demographics
NPI:1952764300
Name:TAJALI, YASSER (MD)
Entity Type:Individual
Prefix:
First Name:YASSER
Middle Name:
Last Name:TAJALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YASER
Other - Middle Name:
Other - Last Name:TAJALIZADEKHOOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:HARTFORD HEALTHCARE-CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:780 LITCHFIELD ST STE 3
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6268
Practice Address - Country:US
Practice Address - Phone:860-972-3600
Practice Address - Fax:860-626-8233
Is Sole Proprietor?:No
Enumeration Date:2016-04-02
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT721532084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology