Provider Demographics
NPI:1750605382
Name:SHORE, RAYME LAUREN (MD)
Entity type:Individual
Prefix:DR
First Name:RAYME
Middle Name:LAUREN
Last Name:SHORE
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 1:675 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2006
Mailing Address - Country:US
Mailing Address - Phone:203-250-3000
Mailing Address - Fax:203-250-3012
Practice Address - Street 1:675 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2006
Practice Address - Country:US
Practice Address - Phone:203-250-3000
Practice Address - Fax:203-250-3012
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT052867207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program