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General NPI Number Information
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NPI Number | 1699746339
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Entity Type | Individual
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Provider Name | MEREDITH RAE GERSHON MD
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Gender | Female
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 888 WHITE PLAINS RD STE 202
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City | TRUMBULL
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State | CT
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Zip | 06611-4552
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Country | US
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Telephone | 203-365-6565
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Fax | 203-365-6567
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Provider Business Mailing Address
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Address Line | 46 PRINCE ST STE 203
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City | NEW HAVEN
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State | CT
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Zip | 06519-1600
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Country | US
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Telephone | 203-787-6161
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Fax | 203-776-0300
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 042196
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License Number State | CT
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