Individual
SHANNON LEIGH MAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
33 COSEY BEACH AVE, EAST HAVEN, CT 06512-4905
(413) 530-1813
(203) 867-5509
Mailing address
33 COSEY BEACH AVE, EAST HAVEN, CT 06512
(413) 530-1813
(203) 867-5509
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001221
CT
Other
Enumeration date
01/23/2007
Last updated
02/22/2016
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