Healthcare Provider Details
I. General information
NPI: 1982328670
Provider Name (Legal Business Name): DR. EYEFIT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2022
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 CHURCH HILL RD
NEWTOWN CT
06470-1639
US
IV. Provider business mailing address
237 STADLEY ROUGH RD
DANBURY CT
06811-3235
US
V. Phone/Fax
- Phone: 203-426-5586
- Fax:
- Phone: 347-733-0594
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
VLADISLAV
KOYFMAN
Title or Position: OPTOMETRIST
Credential: OD
Phone: 203-426-5586