Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 68700 | CT |
N | 2080P0208X | Pediatric Infectious Diseases | LP03805 | RI |
NPI | 1104370030 |
---|---|
Provider Name | Sara Khalife |
First Address | New Haven, CT 06519-1233 |
Second Address | New Haven, CT 06519-1233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2016 |
Last Update Date | 14/07/2021 |