Ebtisam Faddoul, PA-C

NPI #1114294055 in Stamford, Connecticut

Provider Information

NPI Number: 1114294055
Entity Type: Individual
Name: Ebtisam Faddoul, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Nov 21, 2011
Last Updated: Jul 19, 2022

Practice Location

Address: 29 HOSPITAL PLZ STE 501
City: Stamford
State: Connecticut
ZIP Code: 06902-3602
Phone: (203) 276-4400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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