Fiel-Gan, Mary Desiree
Fiel-Gan, Mary Desiree is an individual health care provider with primary practice located at 99 E River Dr 5Th Floor, East Hartford CT 06108-3288. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Fiel-Gan, Mary Desiree can be contacted via phone (860) 282-4133.Contact Information
Primary practice address
99 E River Dr 5Th Floor
East Hartford CT 06108-3288
Phone: (860) 282-4133
Fax: (860) 289-0746
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 037621 | Connecticut |
Profile Details
| NPI number | 1710968961 |
|---|---|
| LBN Legal business name | Fiel-Gan, Mary Desiree |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2005 |
| Last updated | Jun 21st, 2024 - about 5 months 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 | 1710968961 | NPPES |
| Other | 0-457-663-3 | ECFMG | |
| MEDICAID | 001376210 | ECFMG |
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