Healthcare Provider Details

I. General information

NPI: 1871655951
Provider Name (Legal Business Name): OPHTHALMIC ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 HAWLEY LN STE 107
TRUMBULL CT
06611-5300
US

IV. Provider business mailing address

160 HAWLEY LN STE 107
TRUMBULL CT
06611-5300
US

V. Phone/Fax

Practice location:
  • Phone: 203-378-3224
  • Fax: 203-378-2968
Mailing address:
  • Phone: 203-378-3224
  • Fax: 203-378-2968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWARD A. PULICE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 203-378-3224