Healthcare Provider Details

I. General information

NPI: 1407490055
Provider Name (Legal Business Name): OCULUSDOCS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2019
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 ADDISON RD STE 105
GLASTONBURY CT
06033-5608
US

IV. Provider business mailing address

221 ADDISON RD STE 105
GLASTONBURY CT
06033-5608
US

V. Phone/Fax

Practice location:
  • Phone: 860-838-3838
  • Fax: 860-838-3840
Mailing address:
  • Phone: 860-838-3838
  • Fax: 860-838-3840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNY Y. CHA
Title or Position: OWNER/MEMBER
Credential: O.D.
Phone: 860-916-4753