Provider Demographics
NPI:1932821212
Name:SHAIKH, SALENA
Entity Type:Individual
Prefix:
First Name:SALENA
Middle Name:
Last Name:SHAIKH
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 1:15 PEZZENTE LN
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-1451
Mailing Address - Country:US
Mailing Address - Phone:860-966-0993
Mailing Address - Fax:
Practice Address - Street 1:15 PEZZENTE LN
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-1451
Practice Address - Country:US
Practice Address - Phone:860-966-0993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator