Individual
ATIKAH B FATHOLRAZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
35 PARK ST, NEW HAVEN, CT 06519-1110
(914) 434-7043
Mailing address
900 CHAPEL ST APT 412, NEW HAVEN, CT 06510-2802
(914) 434-7043
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
198643
CT
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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