Ebtisam Faddoul, PA-C - Medicare Physician Assistant in Stamford, CT

Ebtisam Faddoul, PA-C is a medicare enrolled "Physician Assistant" in Stamford, Connecticut. Her current practice location is 29 Hospital Plz Ste 501, Stamford, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 276-4400.

Ebtisam Faddoul is licensed to practice in New York (license number 015255-1) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114294055.

Contact Information

Ebtisam Faddoul, PA-C
29 Hospital Plz Ste 501,
Stamford, CT 06902-3602
(203) 276-4400
(203) 276-4401



Provider's Profile

Full NameEbtisam Faddoul
GenderFemale
SpecialityPhysician Assistant
Location29 Hospital Plz Ste 501, Stamford, Connecticut
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114294055
  • Provider Enumeration Date: 11/21/2011
  • Last Update Date: 07/19/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 3678850583
  • Enrollment ID: I20201109001545

Medical Identifiers

Medical identifiers for Ebtisam Faddoul such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114294055NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 015255-1 (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ebtisam Faddoul is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ebtisam Faddoul, PA-C
29 Hospital Plz Ste 501,
Stamford, CT 06902-3602

Ph: (203) 276-4400
Ebtisam Faddoul, PA-C
29 Hospital Plz Ste 501,
Stamford, CT 06902-3602

Ph: (203) 276-4400

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Physician Assistant Nurses in Stamford, CT

Christine Muniz,
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 805 Atlantic St, Stamford, CT 06902
Phone: 203-327-5111    Fax: 203-327-2991
Mr. Mathias Aihiokhai, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1 Hospital Plz, Stamford, CT 06902
Phone: 203-276-1000    
Caitlin Talbot, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1 Hospital Plaza, Stamford, CT 06904
Phone: 203-276-1000    
Krista Ann Ulrich, PHYSICIAN ASSISTANT
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1 Hospital Plz, Stamford, CT 06902
Phone: 203-276-7022    Fax: 203-276-5560
Jeffrey Hamrlicek, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1 Hospital Plz, Stamford, CT 06902
Phone: 203-276-7022    Fax: 203-276-5560
Gregory Jude Jenkins, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1 Hospital Plaza, Stamford, CT 06902
Phone: 203-276-7022    Fax: 203-276-5560
Maggie Giambalvo, PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 1177 Summer St Fl 5, Stamford, CT 06905
Phone: 203-353-1133    Fax: 203-653-3398

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