Fattaleh, Raja
Fattaleh, Raja is an sole proprietor health care provider with primary practice located at 353 Pomfret St , Putnam CT 06260-1835. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Fattaleh, Raja can be contacted via phone (860) 928-1111.Contact Information
Primary practice address
353 Pomfret St
Putnam CT 06260-1835
Phone: (860) 928-1111
Fax: (860) 963-7756
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 038188 | Connecticut |
Profile Details
| NPI number | 1841283439 |
|---|---|
| LBN Legal business name | Fattaleh, Raja |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2005 |
| Last updated | Nov 4th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841283439 | NPPES |
| Connecticut | MEDICAID | 001381889 |
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