Provider Demographics
NPI:1235650318
Name:RICHARD, SHEA OREIN
Entity Type:Individual
Prefix:MRS
First Name:SHEA
Middle Name:OREIN
Last Name:RICHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TROTTERS WAY
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1643
Mailing Address - Country:US
Mailing Address - Phone:203-565-8968
Mailing Address - Fax:
Practice Address - Street 1:12 TROTTERS WAY
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1643
Practice Address - Country:US
Practice Address - Phone:203-565-8968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program