Basic Information
| Provider Information | |||||||||
| NPI: | 1558387571 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURIEL | ||||||||
| FirstName: | SHYLA | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 67 MAPLE AVE | ||||||||
| Address2: | |||||||||
| City: | DERBY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064181328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037321330 | ||||||||
| FaxNumber: | 2037321332 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 MAIN ST STE 1A | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064781065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038885527 | ||||||||
| FaxNumber: | 2038883727 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 04/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 040015 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 110234800 | 01 | CT | RAILROAD MEDICARE PTAN | OTHER | 5749774 | 01 | CO | CIGNA HEALTHCARE OF CT | OTHER | CV5253 | 01 | CT | HEALTHNET | OTHER | P2625841 | 01 | CO | OXFORD HEALTH PLANS | OTHER | 010040015CT01 | 01 | CT | ANTHEM BLUE CROSS BLUE SH | OTHER | 061394494 | 01 | CT | UNITED HEALTHCARE | OTHER | 2895920 | 01 | CT | AETNA | OTHER | 040015 | 01 | CT | CONNECTICARE, INC. & AFFI | OTHER | 001400150 | 05 | CT | MEDICAID |