Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | N8655 | TX |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 53294 | CT |
NPI | 1104115872 |
---|---|
Provider Name | Nada Ghoneim |
First Address | Norwalk, CT 06851-4258 |
Second Address | Hartford, CT 06106-3322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2011 |
Last Update Date | 28/11/2018 |