Healthcare Provider Details

I. General information

NPI: 1962850347
Provider Name (Legal Business Name): ADEEL SHAKIL ZUBAIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 YORK ST YNHH DEPT OF MEDICINE, LMP 1092
NEW HAVEN CT
06510-3221
US

IV. Provider business mailing address

20 YORK ST DEPARTMENT OF NEUROLOGY
NEW HAVEN CT
06510-3220
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-5555
  • Fax:
Mailing address:
  • Phone: 203-688-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number66426
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number66426
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: