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General NPI Number Information
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NPI Number | 1629381132
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Entity Type | Individual
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Provider Name | ANNIE SHAJI DANIEL MD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 2150 CORBIN AVE
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City | NEW BRITAIN
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State | CT
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Zip | 06053-2298
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Country | US
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Telephone | 860-612-6305
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Fax | 860-612-6304
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Provider Business Mailing Address
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Address Line | 2150 CORBIN AVE
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City | NEW BRITAIN
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State | CT
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Zip | 06053-2298
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Country | US
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Telephone | 860-612-6305
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Fax | 860-612-6304
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 054504
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | 054504
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License Number State | CT
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