Provider Demographics
NPI:1801094479
Name:ASLAM, MAHBOOB AHMAD (MD)
Entity type:Individual
Prefix:DR
First Name:MAHBOOB
Middle Name:AHMAD
Last Name:ASLAM
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 1:546 CROMWELL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1800
Mailing Address - Country:US
Mailing Address - Phone:860-969-1101
Mailing Address - Fax:860-838-8170
Practice Address - Street 1:546 CROMWELL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1800
Practice Address - Country:US
Practice Address - Phone:860-757-3874
Practice Address - Fax:860-757-3875
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0476432084B0040X, 2084P0800X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry