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General NPI Number Information
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NPI Number | 1518211879
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Entity Type | Organization
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Legal Business Name | GERARD MICHAEL NOLAN MD PC
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Dates
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Enumeration Date | 11/07/2012
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 1 FOREST PARK DR
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City | FARMINGTON
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State | CT
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Zip | 06032-1487
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Country | US
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Telephone | 860-674-9627
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Fax | 860-676-8622
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Provider Business Mailing Address
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Address Line | 1 FOREST PARK DR P O BOX 827
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City | FARMINGTON
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State | CT
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Zip | 06032-1487
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Country | US
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Telephone | 860-674-9627
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Fax | 860-676-8622
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | DR. GERARD MICHAEL NOLAN
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Credential | MD
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Telephone | 860-674-9627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 22587
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License Number State | CT
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