Healthcare Provider Details

I. General information

NPI: 1063465763
Provider Name (Legal Business Name): OPTICARE EYE HEALTH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 E MAIN ST
TORRINGTON CT
06790-3930
US

IV. Provider business mailing address

87 GRANDVIEW AVE
WATERBURY CT
06708-2514
US

V. Phone/Fax

Practice location:
  • Phone: 860-496-8668
  • Fax: 860-496-7052
Mailing address:
  • Phone: 203-574-2020
  • Fax: 203-596-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: NANCY A NOLL
Title or Position: EXEC VP
Credential:
Phone: 203-574-2020