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General NPI Number Information
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NPI Number | 1811129620
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Entity Type | Organization
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Legal Business Name | SHAHEEN MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 08/12/2009
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Last Update Date | 08/12/2009
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Provider Practice Location Address
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Address Line | 397 BRIDGEPORT AVE
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City | MILFORD
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State | CT
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Zip | 06460-4151
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Country | US
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Telephone | 203-874-0555
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Fax | 203-874-0559
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Provider Business Mailing Address
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Address Line | 315 HOLLOW RD
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City | ORANGE
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State | CT
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Zip | 06477-2817
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Country | US
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Telephone | 203-795-5196
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MUZIANA S QUADIR
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Credential | M.D.
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Telephone | 203-710-5657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 045912
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License Number State | CT
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