Individual
DR. XAVIAN TERRENCE SHAW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
24 HOSPITAL AVE, DANBURY, CT 06810-6077
(866) 374-0007
Mailing address
266 S 9TH AVE APT C, MOUNT VERNON, NY 10550-3743
(917) 371-7940
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
170803
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
9244
CT
Other
Enumeration date
09/29/2020
Last updated
08/14/2022
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