Individual
DR. WAEL ELMALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MSC, PHD
Contact information
Practice address
1 LAKE ST, SUITE 204, NEW BRITAIN, CT 06052-1396
(860) 223-0220
Mailing address
2110 SILAS DEANE HWY, ROCKY HILL, CT 06067-2353
(860) 258-3480
(860) 571-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35. 091561
OH
207RA0002X
Adult Congenital Heart Disease Physician
55451
CT
207RC0000X
Cardiovascular Disease Physician
55451
CT
207RI0011X
Interventional Cardiology Physician
Primary
55451
CT
208000000X
Pediatrics Physician
35. 091561
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D400332473
—
CT
Enumeration date
05/17/2007
Last updated
02/02/2022
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