Individual
IQRA WALAYAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 NEW LONDON TPKE STE 211, GLASTONBURY, CT 06033-2246
(860) 891-2557
Mailing address
42 TIBER AVE, DEER PARK, NY 11729-7012
(516) 853-4685
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14800
CT
1223G0001X
General Practice Dentistry
Primary
14800
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/13/2025
Last updated
06/12/2026
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