Healthcare Provider Details
I. General information
NPI: 1356803175
Provider Name (Legal Business Name): SHAYLA ALARA MENA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/01/2019
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
164 MOUNT PLEASANT RD STE 200
NEWTOWN CT
06470-1477
US
IV. Provider business mailing address
777 MAIN ST UNIT 2503
HARTFORD CT
06103-2326
US
V. Phone/Fax
- Phone: 203-885-1441
- Fax:
- Phone: 517-643-0803
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 35.148222 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 78092 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | MD-55416 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: