Individual provider · NPI-1

Hisham Al Kukhun, MD

Hospitalist · New Haven, CT

NPI number1497273239
StatusActive
Last updated in NPPESJul 30, 2020

Details

NPI
1497273239
Entity type
Individual (NPI-1)
Name
Hisham Al Kukhun
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Aug 31, 2017
Certification date
Jul 30, 2020
Last updated
Jul 30, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208M00000X Hospitalist64253CTYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

20 York Street, Cb-2041
New Haven, CT 06510-3220

Phone 203-688-4748 · Fax 203-688-4740

Mailing address

20 York Street, Cb-2041
Internal Medicine
New Haven, CT 06510-3220

Phone 203-688-4748 · Fax 203-688-4740

Other practice locations

55 Lake Ave N
Worcester, MA 01655-0002

Phone 508-334-1000

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