# PRIORITY FAMILY HEALTHCARE OF NORTHEAST CONNECTICUT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720391311
- **Authorized official:** RAJA FATTALEH MD (OWNER)
- **Authorized official phone:** (860) 928-1111

## Contact information

- **Practice address:** 353 POMFRET ST, PUTNAM, CT 06260-1835
- **Practice address phone:** (860) 928-1111
- **Mailing address:** PO BOX 333, PUTNAM, CT 06260-0333
- **Mailing address phone:** (860) 928-1111
- **Mailing address fax:** (860) 963-7756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 038188 | CT | Yes |

## Other

- **Enumeration date:** 07/23/2010
- **Last updated:** 01/15/2015