Individual
SHANE DUELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
34 MAPLE ST, NORWALK, CT 06850-3815
(203) 852-2188
Mailing address
833 ROLINS RUN, WEBSTER, NY 14580-8400
(585) 281-4109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4993
CT
363AS0400X
Surgical Physician Assistant
4993
CT
Other
Enumeration date
03/28/2020
Last updated
06/23/2021
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