Individual
MANASI M SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, CANCER CENTER, FARMINGTON, CT 06030-2875
(860) 679-2100
(860) 679-4815
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT OFFICE, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
047829
CT
207RH0003X
Hematology & Oncology Physician
047829
CT
Other
Enumeration date
10/03/2008
Last updated
09/27/2012
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