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General NPI Number Information
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NPI Number | 1225224694
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Entity Type | Organization
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Legal Business Name | YOUNG EYES, LLC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 25 CHURCH HILL RD UNIT 205
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City | NEWTOWN
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State | CT
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Zip | 06470-1639
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Country | US
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Telephone | 203-733-7877
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Fax |
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Provider Business Mailing Address
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Address Line | 10 FAWNWOOD RD
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City | SANDY HOOK
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State | CT
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Zip | 06482-1400
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Country | US
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Telephone | 203-733-7877
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JOSEPH KEITH YOUNG
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Credential | OD
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Telephone | 203-733-7877
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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 | 002528
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License Number State | CT
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