Provider Demographics
NPI:1073700548
Name:ALTALIB, HAMADA HAMID (DO,MPH)
Entity Type:Individual
Prefix:DR
First Name:HAMADA
Middle Name:HAMID
Last Name:ALTALIB
Suffix:
Gender:M
Credentials:DO,MPH
Other - Prefix:
Other - First Name:HAMADA
Other - Middle Name:
Other - Last Name:HAMID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO, MPH
Mailing Address - Street 1:150 ROYDON RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2859
Mailing Address - Country:US
Mailing Address - Phone:203-937-4724
Mailing Address - Fax:
Practice Address - Street 1:950 CAMPBELL AVE
Practice Address - Street 2:NEUROLOGY-125
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2770
Practice Address - Country:US
Practice Address - Phone:203-937-4724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0468032084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology