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General NPI Number Information
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NPI Number | 1891195830
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Entity Type | Individual
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Provider Name | GREGORY JAMES NIGRELLI O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 29 BUCKLAND ST
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City | MANCHESTER
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State | CT
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Zip | 06042-1601
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Country | US
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Telephone | 860-646-6655
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Fax | 860-647-7872
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Provider Business Mailing Address
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Address Line | 1041 POQUONNOCK RD
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City | GROTON
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State | CT
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Zip | 06340-4211
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Country | US
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Telephone | 860-445-1000
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Fax | 860-445-4991
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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 | 002923
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License Number State | CT
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