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General NPI Number Information
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NPI Number | 1295042448
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Entity Type | Individual
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Provider Name | BETH A SALONIA O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 10/24/2010
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Provider Practice Location Address
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Address Line | 380 W MAIN ST
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City | AVON
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State | CT
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Zip | 06001-3690
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Country | US
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Telephone | 860-409-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 4 BOW LN
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City | CROMWELL
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State | CT
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Zip | 06416-1233
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Country | US
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Telephone | 860-930-0950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 002819
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License Number State | CT
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