Individual
DR. RAFIK SIDAROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
34 PARK ST, NEW HAVEN, CT 06519-1109
(203) 974-7169
Mailing address
2039 FOREST AVE STE 201, SAN JOSE, CA 95128-4815
(408) 358-8090
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
54819
CT
2084F0202X
Forensic Psychiatry Physician
Primary
A173156
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/31/2012
Last updated
12/30/2021
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