Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 55228 | CT |
Y | 208600000X | Surgeon | 55228 | CT |
N | 2086S0102X | Surgical Critical Care | 55228 | CT |
NPI | 1023306875 |
---|---|
Provider Name | Dr. Mona Taleb |
First Address | Cheshire, CT 06410-3569 |
Second Address | Roanoke Rapids, NC 27870-4914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2011 |
Last Update Date | 03/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14351923 | CAQH (01) | |
4301505224 | MICHIGAN STATE MEDICAL LICENSE (01) | MI |
55228 | CONNECTICUT STATE MEDICAL LICENSE (01) | CT |