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General NPI Number Information
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NPI Number | 1073561767
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Entity Type | Organization
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Legal Business Name | CONSULTING OPHTHALMOLOGISTS, PC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 499 FARMINGTON AVENUE SUITE 100
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City | FARMINGTON
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State | CT
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Zip | 06032
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Country | US
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Telephone | 860-674-7606
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Fax | 860-678-0224
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Provider Business Mailing Address
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Address Line | 499 FARMINGTON AVENUE SUITE 100
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City | FARMINGTON
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State | CT
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Zip | 06032-3515
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Country | US
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Telephone | 860-674-7606
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Fax | 860-678-0224
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Authorized Official
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Title or Position | DIRECTOR OF HIT
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Name | MARIA ANN MAZZOCCOLI
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Credential |
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Telephone | 860-678-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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