Provider Demographics
NPI:1083794812
Name:SHENDER, ANNA (MD, DO)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:SHENDER
Suffix:
Gender:F
Credentials:MD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 GLENBROOK RD STE 400
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:203-961-8241
Mailing Address - Fax:
Practice Address - Street 1:66 GLENBROOK RD STE 400
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-961-8241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000498207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT223637611OtherTAX ID
CT223637611OtherTAX ID
CT110007699Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER