Individual
BENNETT A SHAYWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 YORK ST, YNHH CHILDREN'S HOSPITAL, WEST PAVILION, 2ND FLOOR, NEW HAVEN, CT 06510-3220
(203) 785-4081
(203) 785-5383
Mailing address
20 YORK ST, YNHH CHILDREN'S HOSPITAL, WEST PAVILION, 2ND FLOOR, NEW HAVEN, CT 06510-3220
(203) 785-4081
(203) 785-5383
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
015765
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001157650
—
CT
Enumeration date
12/14/2005
Last updated
04/04/2011
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