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General NPI Number Information
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NPI Number | 1265719223
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Entity Type | Organization
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Legal Business Name | NEW CANAAN OPHTHALMOLOGY LLC
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/13/2013
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Provider Practice Location Address
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Address Line | 11 BURTIS AVE SUITE 203
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City | NEW CANAAN
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State | CT
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Zip | 06840-5532
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Country | US
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Telephone | 203-966-6800
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Fax | 203-966-7721
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Provider Business Mailing Address
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Address Line | 11 BURTIS AVE SUITE 203
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City | NEW CANAAN
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State | CT
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Zip | 06840-5532
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Country | US
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Telephone | 203-966-6800
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Fax | 203-966-7721
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Authorized Official
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Title or Position | MD, OWNER
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Name | DR. JAMES W TALBOT
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Credential | MD
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Telephone | 203-966-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 025637
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License Number State | CT
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