Provider Demographics
NPI:1629452420
Name:PATEL, RESHMA S (OD)
Entity type:Individual
Prefix:
First Name:RESHMA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2389 MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4617
Mailing Address - Country:US
Mailing Address - Phone:845-825-2750
Mailing Address - Fax:
Practice Address - Street 1:181 SHUNPIKE RD STE B
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-1143
Practice Address - Country:US
Practice Address - Phone:860-342-8700
Practice Address - Fax:860-342-8900
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008320152W00000X
CT2956152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist