Shader, Laurel B
Shader, Laurel B is an individual health care provider with primary practice located at 374 Grand Ave Fair Haven Community Health Ctr, New Haven CT 06513. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Shader, Laurel B can be contacted via phone (203) 777-7411.Contact Information
Primary practice address
374 Grand Ave Fair Haven Community Health Ctr
New Haven CT 06513
Phone: (203) 777-7411
Fax: (203) 777-8506
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 028282 | Connecticut |
Profile Details
| NPI number | 1356445415 |
|---|---|
| LBN Legal business name | Shader, Laurel B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 11th, 2006 |
| Last updated | Jan 29th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356445415 | NPPES |
| Other | 004235736 | COMMUNITY HEALTH NETWORK | |
| Other | 5175619 | COMMUNITY HEALTH NETWORK | |
| Other | 1051526 | COMMUNITY HEALTH NETWORK | |
| Other | 0282829734 | COMMUNITY HEALTH NETWORK | |
| Other | P473785 | COMMUNITY HEALTH NETWORK | |
| MEDICAID | 004235736 | COMMUNITY HEALTH NETWORK | |
| Other | 010028282CT03 | COMMUNITY HEALTH NETWORK |
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