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General NPI Number Information
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NPI Number | 1326216771
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Entity Type | Organization
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Legal Business Name | PETER J. STEIN LLC
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 600 NEW HAVEN AVE
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City | DERBY
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State | CT
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Zip | 06418-2507
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Country | US
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Telephone | 203-732-4916
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Fax | 203-735-4431
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Provider Business Mailing Address
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Address Line | 600 NEW HAVEN AVE
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City | DERBY
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State | CT
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Zip | 06418-2507
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Country | US
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Telephone | 203-732-4916
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Fax | 203-735-4431
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER J. STEIN
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Credential | O.D.
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Telephone | 203-732-4916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 002336
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License Number State | CT
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