Organization
SEDAT S. SHABAN, M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEDAT SELAJDIN SHABAN M.D. (OWNER)
(203) 755-1464
Entity
Organization
Contact information
Practice address
1389 W MAIN ST, SUITE 308, WATERBURY, CT 06708-3104
(203) 755-1464
(203) 754-7721
Mailing address
1389 W MAIN ST, SUITE 308, WATERBURY, CT 06708-3104
(203) 755-1464
(203) 754-7721
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
019493
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001194935
—
CT
Enumeration date
01/23/2012
Last updated
01/23/2012
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