Provider Demographics
NPI:1669625174
Name:FATTAHI, POOIA (MD)
Entity type:Individual
Prefix:DR
First Name:POOIA
Middle Name:
Last Name:FATTAHI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:SUITE 307 - WATERBURY NEUROLOGY LLC
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1836
Mailing Address - Country:US
Mailing Address - Phone:203-758-2635
Mailing Address - Fax:203-758-2571
Practice Address - Street 1:1625 STRAITS TPKE
Practice Address - Street 2:SUITE 307 - WATERBURY NEUROLOGY LLC
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1836
Practice Address - Country:US
Practice Address - Phone:203-758-2635
Practice Address - Fax:203-758-2571
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2015-02-06
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Provider Licenses
StateLicense IDTaxonomies
CT50832207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery