Fantarella, Eliza

Fantarella, Eliza is an individual health care provider with primary practice located at 330 Orchard St , New Haven CT 06511. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as her primary health care specialty. Fantarella, Eliza can be contacted via phone (203) 789-3152.

Contact Information

Primary practice address
330 Orchard St New Haven CT 06511
Phone: (203) 789-3152
Fax: (203) 867-5457
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 000867 Connecticut

Profile Details

NPI number 1437319019
LBN Legal business name Fantarella, Eliza
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2008
Last updated Jun 30th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437319019 NPPES
Connecticut MEDICAID 1437319019

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