Macaron, Shady

Macaron, Shady is an individual health care provider with primary practice located at 56 Franklin St , Waterbury CT 06706-1253. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Macaron, Shady can be contacted via phone (203) 709-6000.

Contact Information

Primary practice address
56 Franklin St Waterbury CT 06706-1253
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 045869 Connecticut

Profile Details

NPI number 1528241080
LBN Legal business name Macaron, Shady
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2007
Last updated Oct 28th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528241080 NPPES
Connecticut Other 045869 CONNECTICARE
Connecticut Other PENDING CONNECTICARE
Connecticut Other 969161 CONNECTICARE

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