Healthcare Provider Details

I. General information

NPI: 1003940743
Provider Name (Legal Business Name): OCULUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 W MAIN ST LENSCRAFTERS
AVON CT
06001-3690
US

IV. Provider business mailing address

380 W MAIN ST LENSCRAFTERS
AVON CT
06001-3690
US

V. Phone/Fax

Practice location:
  • Phone: 860-409-4565
  • Fax:
Mailing address:
  • Phone: 860-409-4565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHARON HENDERSON
Title or Position: OPTOMETRIST OWNER
Credential: OD
Phone: 860-409-4565