Individual
DR. HANSA H SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
399 MILL HILL AVE, BRIDGEPORT, CT 06610-2865
(888) 822-2270
(203) 336-4395
Mailing address
399 MILL HILL AVE, BRIDGEPORT, CT 06610-2865
(888) 822-2270
(203) 336-4395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
019875
CT
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
019875
CT
2084P0804X
Child & Adolescent Psychiatry Physician
019875
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004052023
—
CT
05
—
004188282
—
CT
05
—
004191962
—
CT
05
—
004238764
—
CT
05
—
004258366
—
CT
05
—
004258374
—
CT
05
—
004259025
—
CT
Enumeration date
06/01/2007
Last updated
06/26/2008
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