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General NPI Number Information
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NPI Number | 1497284897
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Entity Type | Organization
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Legal Business Name | D&L EYECARE
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 06/08/2017
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Provider Practice Location Address
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Address Line | 33 WELLES STREET
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City | GLASTONBURY
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State | CT
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Zip | 06033
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Country | US
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Telephone | 860-633-1401
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Fax |
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Provider Business Mailing Address
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Address Line | 33 WELLES ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-2047
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. LAUREN GUZIK
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Credential | OD
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Telephone | 860-633-1401
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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 | 2701
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License Number State | CT
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