| NPI | 1790114866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL DULINA Credentialing Coordinator 203-573-4803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CT 001610) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2017-05-24 |