Provider Demographics
NPI:1770836827
Name:SHILO, NATALIE REBECCA (MD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:REBECCA
Last Name:SHILO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR ST STE 500
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5524
Mailing Address - Country:US
Mailing Address - Phone:860-837-7564
Mailing Address - Fax:
Practice Address - Street 1:85 SEYMOUR ST STE 500
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5524
Practice Address - Country:US
Practice Address - Phone:860-837-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT566112080P0214X
CAA1230602080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology