Basic Information
Provider Information
NPI: 1821009853
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHEAR
FirstName: PERRY
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 305 BLACK ROCK TPKE
Address2:  
City: FAIRFIELD
State: CT
PostalCode: 068255508
CountryCode: US
TelephoneNumber: 2033372600
FaxNumber: 2033372666
Practice Location
Address1: 305 BLACK ROCK TPKE
Address2:  
City: FAIRFIELD
State: CT
PostalCode: 068255508
CountryCode: US
TelephoneNumber: 2033372600
FaxNumber: 2033372666
Other Information
ProviderEnumerationDate: 08/11/2006
LastUpdateDate: 04/18/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X032318CTY Allopathic & Osteopathic PhysiciansNeurological Surgery 

ID Information
IDTypeStateIssuerDescription
010032318CT0701CTANTHEM BC/BSOTHER
2V503201CTHEALTH NETOTHER
TIN01 ORTHONETOTHER
TIN01 PIONEEROTHER
TIN01 NORTHEAST HEALTH DIRECTOTHER
TIN01 CORVELOTHER
017913701CTCIGNAOTHER
372445101CTAETNAOTHER
TIN01 POMCOOTHER
ZS38501CTOXFORD HEALTH PLANSOTHER
00132318805CT MEDICAID
32318001CTCONNECTICAREOTHER
TIN01 UNITED HEALTHCAREOTHER
TIN01 NEHCA HMC / PPOOTHER
TIN01 GREAT WESTOTHER
2M6351(2) (3)01CTEMPIREOTHER
TIN01 FIRST HEALTH / CCNOTHER
TIN01 NATIONAL PROVIDER NETWORKOTHER


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