Healthcare Provider Details
I. General information
NPI: 1942721733
Provider Name (Legal Business Name): NEW INSIGHT FAMILY EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1320 W MAIN ST
WATERBURY CT
06708-3119
US
IV. Provider business mailing address
1320 W MAIN ST
WATERBURY CT
06708-3119
US
V. Phone/Fax
- Phone: 203-755-4941
- Fax: 203-573-8372
- Phone: 203-755-4941
- Fax: 203-573-8372
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 000896 |
| License Number State | CT |
VIII. Authorized Official
Name: DR.
ALBERT
E
GERMAIN
Title or Position: OWNER/DOCTOR
Credential: OD
Phone: 203-755-4941