Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 043117 | CT |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 043117 | CT |
NPI | 1265415350 |
---|---|
Provider Name | Sonya Samir Abdel-Razeq |
First Address | New Haven, CT 06536-0805 |
Second Address | New Haven, CT 06519-1369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 04/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I40162 | (02) |