Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 3135 | CT |
NPI | 1013555226 |
---|---|
Provider Name | Dr. Pari Shah |
First Address | Avon, CT 06001-3717 |
Second Address | Avon, CT 06001-3717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 18/12/2019 |