Provider Demographics
NPI:1215167879
Name:SESHADRI, JAYASREE (OD)
Entity type:Individual
Prefix:
First Name:JAYASREE
Middle Name:
Last Name:SESHADRI
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 1:513 FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-1547
Mailing Address - Country:US
Mailing Address - Phone:781-266-6904
Mailing Address - Fax:
Practice Address - Street 1:91 POINT JUDITH RD
Practice Address - Street 2:SUITE #2
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3445
Practice Address - Country:US
Practice Address - Phone:401-782-2100
Practice Address - Fax:401-782-2101
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIODTG00541152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist