Individual
SHIROMINI HERATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 GRAND ST, MEDICAL STAFF OFFICE ATTN ONDREA CHASSE, NEW BRITAIN, CT 06052-2016
(860) 224-5305
(860) 224-5565
Mailing address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5305
(860) 224-5565
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
045058
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045058
LIC
CT
Enumeration date
01/25/2007
Last updated
09/29/2022
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