Provider Demographics
NPI:1508884560
Name:SHENOI, SHEELA (MD)
Entity Type:Individual
Prefix:
First Name:SHEELA
Middle Name:
Last Name:SHENOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 COLLEGE ST STE 323
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2483
Mailing Address - Country:US
Mailing Address - Phone:203-737-6133
Mailing Address - Fax:203-737-4051
Practice Address - Street 1:15 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3221
Practice Address - Country:US
Practice Address - Phone:203-688-5303
Practice Address - Fax:203-688-3216
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043531207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001435313Medicaid
CTI36927Medicare UPIN
CT001435313Medicaid