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General NPI Number Information
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NPI Number | 1346638533
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Entity Type | Organization
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Legal Business Name | RUTHERFORD VISION CARE, LLC
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 10 CROWNE POND LN
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City | WILTON
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State | CT
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Zip | 06897-3029
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Country | US
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Telephone | 203-974-2294
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Fax | 203-900-8733
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Provider Business Mailing Address
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Address Line | 553 POST RD RUTHERFORD VISION CARE C/O DARIEN EYECARE
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City | DARIEN
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State | CT
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Zip | 06820-3609
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Country | US
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Telephone | 203-878-2020
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Fax | 203-878-1783
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JASON RUTHERFORD
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Credential | O.D.
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Telephone | 203-216-3982
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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 | 2908
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License Number State | CT
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