NPI | 1659695344 |
---|---|
Entity Type | Organization |
Authorized Contact | EUGENE ROBERT BERTOLLI Member 203-238-3080 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist |
Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2015) |
Enumeration Date | 2010-03-24 |
Last Update Date | 2010-11-24 |