Individual
LAUREL B SHADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
374 GRAND AVE, FAIR HAVEN COMMUNITY HEALTH CTR, NEW HAVEN, CT 06513
(203) 777-7411
(203) 777-8506
Mailing address
535 HOWELLTON ROAD, ORANGE, CT 06477
(203) 799-7961
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
028282
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004235736
COMMUNITY HEALTH NETWORK
—
05
—
004235736
—
CT
01
—
010028282CT03
ANTHEM BCBS
—
01
—
0282829734
CONNECTICARE
—
01
—
1051526
AETNA US HEALTHCARE
—
01
—
5175619
CIGNA
—
01
—
P473785
OXFORD
—
Enumeration date
09/11/2006
Last updated
01/29/2009
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