MEDICARE: SHAILA GARASIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	047419	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7301SG	OTHER	NY	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568407245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAILA GARASIA

Provider Business Mailing Address
First Line	:	PO BOX 423
Second Line	:
City	:	PENN YAN
State	:	NY
Zip	:	14527-0423
Country	:	US
Telephone Number	:	315-531-9102
Fax Number	:	315-531-9103

Provider Business Practice Location Address
First Line	:	601B W WASHINGTON ST
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456-2119
Country	:	US
Telephone Number	:	315-781-8448
Fax Number	:	315-781-8444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	02/23/2015

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Directions to “ SHAILA GARASIA ” Practice Location

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