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NPI 1295902112

NPI 1295902112 : STEPHEN LAWRENCE SHIAO MD : NEW HAVEN, CT

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General NPI Number Information
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    NPI Number           |    1295902112
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    Entity Type          |    Individual 
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    Provider Name        |    STEPHEN LAWRENCE SHIAO MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/09/2008
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    Last Update Date     |    01/21/2016
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Provider Practice Location Address
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    Address Line         |    20 YORK STREET T-209 YALE NEW HAVEN HOSPITAL
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    City                 |    NEW HAVEN
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    State                |    CT
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    Zip                  |    06510-3220
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    Country              |    US
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    Telephone            |    203-688-2259
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    Fax                  |    203-688-5599
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Provider Business Mailing Address
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    Address Line         |    20 YORK STREET T-209 YALE NEW HAVEN HOSPITAL
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    City                 |    NEW HAVEN
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    State                |    CT
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    Zip                  |    06510-3220
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    Country              |    US
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    Telephone            |    203-688-2259
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    Fax                  |    203-688-5599
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2085R0001X
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    Taxonomy Name        |    Radiation Oncology Physician
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    License Number       |    A108146
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    License Number State |    CA
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