Healthcare Provider Details

I. General information

NPI: 1912685538
Provider Name (Legal Business Name): JULIET ALICIA PLUCINIK OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 KING ST
BRISTOL CT
06010-9207
US

IV. Provider business mailing address

86 WHITE OAK AVE
PLAINVILLE CT
06062-2528
US

V. Phone/Fax

Practice location:
  • Phone: 860-584-5528
  • Fax:
Mailing address:
  • Phone: 860-302-8478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3300
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: