Shahab, Erum

Shahab, Erum is an sole proprietor health care provider with primary practice located at 16 Main St , Ellington CT 06029-3360. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Shahab, Erum can be contacted via phone (860) 871-5402.

Contact Information

Primary practice address
16 Main St Ellington CT 06029-3360
Phone: (860) 871-5402
Fax: (860) 871-5413
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 043112 Connecticut
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 0431121 Connecticut
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 0431121 Connecticut

Profile Details

NPI number 1669434049
LBN Legal business name Shahab, Erum
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 3rd, 2006
Last updated Dec 21st, 2015 - about 9 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 1669434049 NPPES
Connecticut MEDICAID 1669434049

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