Individual
JEFF SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
(917) 605-3326
Mailing address
30 PEQUONNOCK CIR, STRATFORD, CT 06614-2313
(917) 605-3326
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
153286
CT
363LA2100X
Acute Care Nurse Practitioner
Primary
8927
CT
Other
Enumeration date
04/13/2020
Last updated
09/17/2020
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