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General NPI Number Information
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NPI Number | 1295866242
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Entity Type | Organization
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Legal Business Name | STRATFORD EYECARE ASSOCIATES, L.L.C.
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/02/2010
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Provider Practice Location Address
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Address Line | 1040 BARNUM AVE
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City | STRATFORD
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State | CT
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Zip | 06614-4968
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Country | US
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Telephone | 203-378-2269
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Fax | 203-377-7207
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Provider Business Mailing Address
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Address Line | 1040 BARNUM AVE
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City | STRATFORD
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State | CT
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Zip | 06614-4968
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Country | US
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Telephone | 203-378-2269
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Fax | 203-377-7207
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA ANN CARROLL
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Credential | OD
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Telephone | 203-378-2269
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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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