Qaiyum Mujtaba, M.D., P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16546 Issued in CT

Legal business name

QAIYUM MUJTABA, M.D., P.C.

Practice address

750 Savin Ave
West Haven, CT 06516-4314

Phone

(203) 931-7710

NPI assigned

Jul 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Qaiyum Mujtaba, M. D.

Title

President

Phone

(203) 931-7710

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184371200000",
    "number": "1174722805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 SAVIN AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164314",
            "telephone_number": "203-931-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 SAVIN AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164314",
            "telephone_number": "203-931-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QAIYUM MUJTABA, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-14",
        "status": "A",
        "authorized_official_last_name": "MUJTABA",
        "authorized_official_first_name": "QAIYUM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-931-7710",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "16546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in West Haven, CT
• Providers in West Haven, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.