Healthcare Provider Details

I. General information

NPI: 1609700962
Provider Name (Legal Business Name): DIANE ZOU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 HARTFORD TPKE
WATERFORD CT
06385-4267
US

IV. Provider business mailing address

1236 STRATFIELD RD
FAIRFIELD CT
06825-1365
US

V. Phone/Fax

Practice location:
  • Phone: 860-442-0380
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3469
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: