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Individual

DR. RIMA L FAWAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
800 HOWARD AVE, NEW HAVEN, CT 06519-1369
(203) 785-4649
(203) 737-1384
Mailing address
333 CEDAR STREET, LMP4093, PO BOX 208064, NEW HAVEN, CT 06520-8064
(203) 785-4649
(203) 737-1384

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
222795
MA
2080P0206X
Pediatric Gastroenterology Physician
Primary
64157
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2086191
MA
01
469921
TUFTS HEALTH PLAN
MA
01
J28234
BCBS MA
MA
Enumeration date
11/08/2005
Last updated
10/14/2019
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