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Individual

SHAHANA AYUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
200 RETREAT AVE, HARTFORD, CT 06106-3309
(860) 545-7493
Mailing address
200 RETREAT AVE, HARTFORD, CT 06106-3309
(860) 545-7493

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
75573
CT
2084P0804X
Child & Adolescent Psychiatry Physician
298071
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
75573
CT

Other

Enumeration date
07/08/2014
Last updated
09/12/2023
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