Healthcare Provider Details

I. General information

NPI: 1174641831
Provider Name (Legal Business Name): CFO RETAIL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WEST FARMS MALL #113
FARMINGTON CT
06032
US

IV. Provider business mailing address

WEST FARMS MALL #113
FARMINGTON CT
06032
US

V. Phone/Fax

Practice location:
  • Phone: 860-521-4141
  • Fax: 860-521-8326
Mailing address:
  • Phone: 860-521-4141
  • Fax: 860-521-8326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. DARLEEN CETTINA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 212-729-5373