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NPI Code Detail

MEDICARE: SHRAIY AGRAWAL

MEDICARE:   SHRAIY  AGRAWAL
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
1152W00000XOptometrist009990NY
2390200000XStudent in an Organized Health Care Education/Training Program
3152W00000XOptometrist3350CT

General Provider Information

NPI Number : 1194565903
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHRAIY AGRAWAL
Provider Business Mailing Address
First Line : 375 E MAIN ST UNIT 9
Second Line :
City : BRANFORD
State : CT
Zip : 06405-2963
Country : US
Telephone Number : 347-406-2276
Fax Number :
Provider Business Practice Location Address
First Line : 200B VILLAGE WALK
Second Line :
City : GUILFORD
State : CT
Zip : 06437-2745
Country : US
Telephone Number : 203-458-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2024
Last Update Date : 07/22/2024

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Directions to “ SHRAIY AGRAWAL ” Practice Location

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