Basic Information
| Provider Information | |||||||||
| NPI: | 1225266547 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HATIBOGLU | ||||||||
| FirstName: | NAZMIYE | ||||||||
| MiddleName: | ESRA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28 CRESCENT ST | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064573654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603584820 | ||||||||
| FaxNumber: | 8603588661 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064222100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603491058 | ||||||||
| FaxNumber: | 8603588652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2009 | ||||||||
| LastUpdateDate: | 04/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 052253 | CT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.