Healthcare Provider Details

I. General information

NPI: 1073617767
Provider Name (Legal Business Name): CONNECTICUT EYE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CORPORATE DR STE 380
SHELTON CT
06484-6266
US

IV. Provider business mailing address

4 CORPORATE DR STE 380
SHELTON CT
06484-6266
US

V. Phone/Fax

Practice location:
  • Phone: 203-926-1700
  • Fax: 203-926-0766
Mailing address:
  • Phone: 203-926-1700
  • Fax: 203-926-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number034394
License Number StateCT

VIII. Authorized Official

Name: JOSEPH SOKOL
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 203-926-1700