| NPI | 1821261801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P DECARLO Optometrist 203-327-1511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CT 2021) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 704) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2011-03-15 |