Individual
MARISA LOUISE SHAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1221
(203) 709-3538
(203) 709-7258
Mailing address
PO BOX 1090, WINDSOR, CT 06095-6190
(203) 709-3800
(203) 709-3869
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001133
CT
Other
Enumeration date
07/11/2006
Last updated
09/23/2022
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