Healthcare Provider Details

I. General information

NPI: 1801966601
Provider Name (Legal Business Name): BARBARA HOPE KUZNESOF-KNEE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA H. KUZNESOF O.D.

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 WOLCOTT ST. C/O WALMART VISION CENTER
WATERBURY CT
06705
US

IV. Provider business mailing address

2 SHADY BROOK DR
CROMWELL CT
06416
US

V. Phone/Fax

Practice location:
  • Phone: 203-759-1611
  • Fax: 203-759-1707
Mailing address:
  • Phone: 860-635-5766
  • Fax: 860-788-3055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number002095
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: