MEDICARE: DR. STEPHEN M DINCHER O.D.

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	MD2697172	CT

General Provider Information

NPI Number	:	1750679346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN M DINCHER O.D.

Provider Business Mailing Address
First Line	:	1950 OLD GALLOWS RD STE 520
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-3970
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 MAIN ST N
Second Line	:
City	:	SOUTHBURY
State	:	CT
Zip	:	06488-3840
Country	:	US
Telephone Number	:	203-264-3937
Fax Number	:	203-264-1571

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

Provider Enumeration Date	:	07/15/2011
Last Update Date	:	10/29/2021

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