Healthcare Provider Details

I. General information

NPI: 1003161258
Provider Name (Legal Business Name): MAROUN SFEIR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 08/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVENUE
FARMINGTON CT
06030
US

IV. Provider business mailing address

263 FARMINGTON AVENUE
FARMINGTON CT
06030-8082
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-2980
  • Fax: 860-679-4334
Mailing address:
  • Phone: 860-679-2980
  • Fax: 860-679-4334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number062356
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number062356
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: