Healthcare Provider Details

I. General information

NPI: 1225478803
Provider Name (Legal Business Name): SULEYMAN FELEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 ROBBINS ST DEPARTMENT OF MEDICINE
WATERBURY CT
06708-2613
US

IV. Provider business mailing address

64 ROBBINS ST DEPARTMENT OF MEDICINE
WATERBURY CT
06708-2613
US

V. Phone/Fax

Practice location:
  • Phone: 203-573-6000
  • Fax:
Mailing address:
  • Phone: 203-573-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number055342
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number055342
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: