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General NPI Number Information
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NPI Number | 1427256593
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Entity Type | Organization
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Legal Business Name | DOCTOR PAVANO & ASSOCIATES
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 198 E MAIN ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-1915
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Country | US
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Telephone | 860-223-7900
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Fax | 860-826-7161
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Provider Business Mailing Address
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Address Line | 198 E MAIN ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-1915
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Country | US
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Telephone | 860-223-7900
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Fax | 860-826-7161
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. JOSEPH E PAVANO, III
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Credential | O.D
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Telephone | 860-223-7900
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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 | 002149CT
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License Number State | CT
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