| NPI | 1962632661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SIDERIDES Owner 203-327-5808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 030718) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: CT 001612) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2018-03-22 |