Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 022779 | CT |
N | 2080P0208X | Pediatric Infectious Diseases | 022779 | CT |
NPI | 1306829940 |
---|---|
Provider Name | Eugene D Shapiro |
First Address | New Haven, CT 06511-6624 |
Second Address | New Haven, CT 06519-1369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E31735 | (02) |