Individual ProviderOsama KandalaftInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address20 York Street, Cb-2041, New Haven, CT 06510-3220(203) 688-4748PECOS EnrollmentBased on the most recent information from CMS, provider Osama Kandalaft is legally eligible to order and refer claims for Part B, HHA and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1063868065Provider TypeIndividualFull NameKandalaft, OsamaCredentialMDGenderMaleSole ProprietorNoEnumeration Date5/9/2016Last Updated12/1/2021Contact InformationPractice LocationPractice Address20 York Street, Cb-2041, New Haven, CT 06510-3220Phone(203) 688-4748Fax(203) 688-4740Mailing LocationMailing Address20 York Street, Cb-329, New Haven, CT 06510-3220Phone(203) 688-4748Fax(203) 688-4740Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense063900ConnecticutCode208M00000XDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicense063900ConnecticutCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer