Healthcare Provider Details

I. General information

NPI: 1578696027
Provider Name (Legal Business Name): OCULUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 MAIN ST LENSCRAFTERS
MIDDLETOWN CT
06457-2855
US

IV. Provider business mailing address

460 MAIN ST LENSCRAFTERS
MIDDLETOWN CT
06457-2855
US

V. Phone/Fax

Practice location:
  • Phone: 860-343-6016
  • Fax: 860-347-4797
Mailing address:
  • Phone: 860-343-6016
  • Fax: 860-347-4797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. SHARON HENDERSON
Title or Position: OPTOMETRIST OWNER
Credential: OD
Phone: 860-409-4565