| |
111 East Ave, Suite 335, Norwalk, CT 06851-5014 | |
(203) 853-2020 | |
(203) 852-9553 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 111 East Ave, Norwalk, Connecticut |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376716449 | NPI | - | NPPES |
001338244 | Medicaid | CT | |
01554461 | Other | NY | MEDICAID NY |
07J861 | Other | NY | MEDICARE NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
111 East Ave, Suite 335, Norwalk, CT 06851-5014 Ph: (203) 853-2020 | 111 East Ave, Suite 335, Norwalk, CT 06851-5014 Ph: (203) 853-2020 |