Oec Derby Llc | |
600 New Haven Ave, Derby, CT 06418-2529 | |
(203) 732-4916 | |
(203) 735-4431 |
Full Name | Oec Derby Llc |
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Type | Facility |
Speciality | Optometrist |
Location | 600 New Haven Ave, Derby, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1275287005 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Karen G Bonnanzio |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1508955873 PECOS PAC ID: 8224046842 Enrollment ID: I20060323000463 |
Provider Name | Kurt J Tichy |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1750338414 PECOS PAC ID: 7416969597 Enrollment ID: I20060609000028 |
Provider Name | Tiffany Nicole Deleon |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1760969133 PECOS PAC ID: 9133460298 Enrollment ID: I20190418000550 |
Mailing Address | Practice Location Address |
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Oec Derby Llc 600 New Haven Ave, Derby, CT 06418-2529 Ph: (203) 732-4916 | Oec Derby Llc 600 New Haven Ave, Derby, CT 06418-2529 Ph: (203) 732-4916 |
Dr. Peter J Stein, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 590 New Haven Ave, C/o Pearle Vision, Derby, CT 06418 Phone: 203-732-4916 Fax: 203-735-4431 |