Healthcare Provider Details

I. General information

NPI: 1306519012
Provider Name (Legal Business Name): OCULARPRIME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WALLS DR STE 205
FAIRFIELD CT
06824-5163
US

IV. Provider business mailing address

55 WALLS DR STE 205
FAIRFIELD CT
06824-5163
US

V. Phone/Fax

Practice location:
  • Phone: 203-292-8101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARIA PRIBIS
Title or Position: OWNER
Credential:
Phone: 203-292-8101