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General NPI Number Information
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NPI Number | 1588771810
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Entity Type | Individual
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Provider Name | NANCY Y SHENOUDA-AWAD O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | VA HUDSON VALLEY -FDR CAMPUS, OPTOMETRY SERVICE (620-123)
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City | MONTROSE
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State | NY
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Zip | 10548
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Country | US
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Telephone | 914-737-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 454 RIVERSIDE AVE 2ND FLOOR
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City | WESTPORT
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State | CT
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Zip | 06880-4813
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Country | US
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Telephone | 203-557-4275
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Fax | 203-557-4275
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007049-1
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License Number State | NY
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