| NPI | 1457820235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY DOTY Manager 203-438-2840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| 152WL0500X Optometrist Low Vision Rehabilitation | |
| 152WP0200X Optometrist Pediatrics | |
| 152WS0006X Optometrist Sports Vision | |
| 152WX0102X Optometrist Occupational Vision | |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2020-01-13 |