Provider Demographics
NPI:1699746339
Name:GERSHON, MEREDITH RAE (MD)
Entity type:Individual
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First Name:MEREDITH
Middle Name:RAE
Last Name:GERSHON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:46 PRINCE ST STE 203
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1600
Mailing Address - Country:US
Mailing Address - Phone:203-787-6161
Mailing Address - Fax:203-776-0300
Practice Address - Street 1:888 WHITE PLAINS RD STE 202
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4552
Practice Address - Country:US
Practice Address - Phone:203-365-6565
Practice Address - Fax:203-365-6567
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2023-09-08
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Provider Licenses
StateLicense IDTaxonomies
CT042196207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001421966Medicaid