MEDICARE: JAIME POND

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	156FX1800X	Optician	001586	CT

General Provider Information

NPI Number	:	1497546501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME POND

Provider Business Mailing Address
First Line	:	29 WEST ST
Second Line	:
City	:	LITCHFIELD
State	:	CT
Zip	:	06759-3501
Country	:	US
Telephone Number	:
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	:	05/16/2025
Last Update Date	:	05/16/2025

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Directions to “ JAIME POND ” Practice Location

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