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1114294055
EBTISAM FADDOUL
STAMFORD, CT
NPI
1114294055
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 015255-1)
Enumeration Date
2011-11-21
Last Update Date
2022-07-19
Business Address
EBTISAM FADDOUL PA-C
29 HOSPITAL PLZ STE 501
STAMFORD, CT 06902-3602
Phone number: 203-276-4400
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Mailing Address
EBTISAM FADDOUL PA-C
29 HOSPITAL PLZ STE 501
STAMFORD, CT 06902-3602
Phone number: 203-276-4400
Copy
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