Healthcare Provider Details

I. General information

NPI: 1386534014
Provider Name (Legal Business Name): BETHANY GRACE ARABIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 NORWICH NEW LONDON TPKE UNIT 8
UNCASVILLE CT
06382-1384
US

IV. Provider business mailing address

1920 NORWICH NEW LONDON TPKE UNIT 8
UNCASVILLE CT
06382-1384
US

V. Phone/Fax

Practice location:
  • Phone: 860-848-3388
  • Fax: 860-848-3388
Mailing address:
  • Phone: 860-848-8777
  • Fax: 860-848-3388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number152W00000X
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: