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Individual

LISA E SHAKUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
370 MIDDLE TPKE W, MANCHESTER, CT 06040-3824
(860) 650-3848
Mailing address
31 OLD ROUTE 7, BROOKFIELD, CT 06804-1711
(860) 650-3848

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002236
CT
363A00000X
Physician Assistant
013444
NY
363A00000X
Physician Assistant
PA7540
MA

Other

Enumeration date
02/20/2009
Last updated
03/12/2025
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