| NPI | 1851565618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ROBERT BECKERT Owner 203-265-2205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: CT 1278) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CT 2264) |
| 152W00000X Optometrist (Licence: CT 2262) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |