Organization
WATERBURY NEUROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POOIA FATTAHI MD (PARTNER)
(203) 758-8995
Entity
Organization
Contact information
Practice address
1625 STRAITS TURNPIKE, SUITE 307, MIDDLEBURY, CT 06762-1836
(203) 758-8995
(203) 758-2571
Mailing address
1625 STRAITS TURNPIKE, SUITE 307, MIDDLEBURY, CT 06762-1836
(203) 758-8995
(203) 758-2571
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1284603
—
CT
05
—
1361138
—
CT
Enumeration date
06/02/2006
Last updated
04/29/2016
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