Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 63638 | CT |
Y | 111NI0900X | Internist | 63638 | CT |
NPI | 1003270299 |
---|---|
Provider Name | Shanzay Haider |
First Address | Waterbury, CT 06706-1865 |
Second Address | Waterbury, CT 06706-1253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2016 |
Last Update Date | 03/09/2020 |