Individual
DR. SHADY ELSAMRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
34 PARK ST, NEW HAVEN, CT 06519-1109
(203) 800-1361
Mailing address
34 PARK ST, NEW HAVEN, CT 06519-1109
(203) 800-1361
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1.052793
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008057210
—
CT
Enumeration date
07/03/2009
Last updated
03/05/2015
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