| NPI | 1114078169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN WONG President 203-743-9897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT CT002529) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CT CT002529) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-08-29 |