| NPI | 1548670094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH M MIRTO Practice Manager 203-553-9794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: CT 001647) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2014-07-23 |