Healthcare Provider Details

I. General information

NPI: 1518499367
Provider Name (Legal Business Name): SHIMY APOORVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 GRANDVIEW AVE
WATERBURY CT
06708-2514
US

IV. Provider business mailing address

87 GRANDVIEW AVE
WATERBURY CT
06708-2514
US

V. Phone/Fax

Practice location:
  • Phone: 203-574-2020
  • Fax:
Mailing address:
  • Phone: 203-574-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number71570
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207WX0108X
TaxonomyUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
License Number71570
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: