Provider Demographics
NPI:1396920666
Name:PATEL, SHREYA (OD)
Entity type:Individual
Prefix:DR
First Name:SHREYA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 ANN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5801
Mailing Address - Country:US
Mailing Address - Phone:203-678-3035
Mailing Address - Fax:
Practice Address - Street 1:1240 POST RD E STE 1
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5427
Practice Address - Country:US
Practice Address - Phone:203-557-8426
Practice Address - Fax:844-809-7250
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2610152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist