Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 288399 | MA |
NPI | 1124414958 |
---|---|
Provider Name | Areen Basman Faisal Al-Taie |
First Address | Enfield, CT 06082-2179 |
Second Address | Springfield, MA 01199-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 16/08/2021 |