Healthcare Provider Details

I. General information

NPI: 1326265562
Provider Name (Legal Business Name): RANDY LEIGH SCHULMAN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 MAIN ST
NORWALK CT
06851-3709
US

IV. Provider business mailing address

33 INDIAN RD
TRUMBULL CT
06611-2724
US

V. Phone/Fax

Practice location:
  • Phone: 203-840-1991
  • Fax:
Mailing address:
  • Phone: 203-452-9179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2299
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number2299
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: