=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801748801
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HLTH LAB MEDICAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2026
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 40 E PUTNAM AVE STE 1B
-----------------------------------------------------
City | COS COB
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06807-2606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-409-5329
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 40 E PUTNAM AVE STE 1B
-----------------------------------------------------
City | COS COB
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06807-2606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. JOSHAN K SHAJAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 203-409-5329
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------