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General NPI Number Information
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NPI Number | 1770046369
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Entity Type | Individual
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Provider Name | SAUMYA SHAH MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 27 SYCAMORE ST STE 100
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City | GLASTONBURY
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State | CT
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Zip | 06033-7208
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Country | US
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Telephone | 860-659-0581
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Fax | 860-657-1806
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Provider Business Mailing Address
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Address Line | 30 JORDAN LN
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City | WETHERSFIELD
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State | CT
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Zip | 06109-1278
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Country | US
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Telephone | 860-263-0253
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Fax | 860-263-0262
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 70846
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License Number State | CT
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