Individual
CONNELL SHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
353 MARION ST, BROOKLYN, NY 11233-2415
(347) 683-7858
Mailing address
353 MARION ST, BROOKLYN, NY 11233-2415
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
607162
NY
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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