Healthcare Provider Details

I. General information

NPI: 1619892338
Provider Name (Legal Business Name): OPTOMETRY ASSOCIATES OF NORWICH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 SALEM TPKE
NORWICH CT
06360-6516
US

IV. Provider business mailing address

22 SALEM TPKE
NORWICH CT
06360-6516
US

V. Phone/Fax

Practice location:
  • Phone: 860-886-1155
  • Fax:
Mailing address:
  • Phone: 860-886-1155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JENNIFER CAPSTICK
Title or Position: OPTOMETRIST/OWNER
Credential: OD
Phone: 860-886-1155