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General NPI Number Information
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NPI Number | 1114260171
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Entity Type | Organization
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Legal Business Name | SOUND BEACH OPTIKS,LLC
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 05/21/2013
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Provider Practice Location Address
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Address Line | 177 SOUND BEACH AVE
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City | OLD GREENWICH
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State | CT
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Zip | 06870-1740
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Country | US
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Telephone | 203-637-3120
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Fax |
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Provider Business Mailing Address
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Address Line | 177 SOUND BEACH AVE
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City | OLD GREENWICH
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State | CT
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Zip | 06870-1740
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Country | US
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Telephone | 203-637-3120
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. FRANK POE
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Credential | O.D.
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Telephone | 203-637-3120
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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 | 002313
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License Number State | CT
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