MEDICARE: JENNIFER KAREN STROM OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TUV0064631	NY
2	152W00000X	Optometrist	003383	CT

General Provider Information

NPI Number	:	1053372607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER KAREN STROM OD

Provider Business Mailing Address
First Line	:	29 WEST ST
Second Line	:
City	:	LITCHFIELD
State	:	CT
Zip	:	06759-3501
Country	:	US
Telephone Number	:	860-567-4565
Fax Number	:

Provider Business Practice Location Address
First Line	:	29 WEST ST
Second Line	:
City	:	LITCHFIELD
State	:	CT
Zip	:	06759-3501
Country	:	US
Telephone Number	:	860-567-4565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	09/10/2025

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