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General NPI Number Information
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NPI Number | 1427517085
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Entity Type | Organization
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Legal Business Name | OPTICS AND FASHION BY KV, LLC
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 70 GREEN STREET
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City | HARTFORD
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State | CT
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Zip | 06120-2235
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Country | US
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Telephone | 860-890-9960
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Fax | 860-969-4966
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Provider Business Mailing Address
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Address Line | PO BOX 1168
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City | HARTFORD
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State | CT
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Zip | 06143-1168
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Country | US
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Telephone | 866-717-1370
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Fax | 860-969-4966
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. VIVIAN NOIR
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Credential | L.O.
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Telephone | 860-890-9960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FC0801X
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Taxonomy Name | Contact Lens Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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