| NPI | 1730501651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYE ALGRANATI Member 203-249-5042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 2209) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CT 2209) |
| 152WS0006X Optometrist, Sports Vision (Licence: CT 2209) | |
| Enumeration Date | 2014-01-12 |
| Last Update Date | 2014-01-12 |