Shahab, Erum
Shahab, Erum is an sole proprietor health care provider with primary practice located at 16 Main St , Ellington CT 06029-3360. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Shahab, Erum can be contacted via phone (860) 871-5402.Contact Information
Primary practice address
16 Main St
Ellington CT 06029-3360
Phone: (860) 871-5402
Fax: (860) 871-5413
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 043112 | Connecticut |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 0431121 | Connecticut |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 0431121 | Connecticut |
Profile Details
| NPI number | 1669434049 |
|---|---|
| LBN Legal business name | Shahab, Erum |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 3rd, 2006 |
| Last updated | Dec 21st, 2015 - about 10 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 | 1669434049 | NPPES |
| Connecticut | MEDICAID | 1669434049 |
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