Individual
DR. RAPHAEL NDEDE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
64 ROBBINS ST, WATERBURY, CT 06708-2600
(203) 673-6000
Mailing address
11A GARIT LN, LARCHMONT, NY 10538-3314
(347) 886-3075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
292465
NY
207R00000X
Internal Medicine Physician
56674
CT
207RI0200X
Infectious Disease Physician
Primary
292465
NY
207RI0200X
Infectious Disease Physician
56674
CT
208M00000X
Hospitalist Physician
56674
CT
208M00000X
Hospitalist Physician
MD28262
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04842339
—
NY
Enumeration date
05/30/2014
Last updated
07/16/2025
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