Healthcare Provider Details

I. General information

NPI: 1851315170
Provider Name (Legal Business Name): LOUIS G HOCHBERG O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 DIXWELL AVE
HAMDEN CT
06514-2116
US

IV. Provider business mailing address

8614 WESTWOOD CENTER DR FL 9
VIENNA VA
22182-2442
US

V. Phone/Fax

Practice location:
  • Phone: 203-407-3937
  • Fax: 203-407-3932
Mailing address:
  • Phone: 703-847-8899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number947
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: