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General NPI Number Information
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NPI Number | 1548240146
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Entity Type | Individual
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Provider Name | HOPE BERNARD MARANDOLA O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 03/14/2014
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Provider Practice Location Address
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Address Line | 10 NORWICH RD.
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City | CENTRAL VILLAGE
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State | CT
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Zip | 06332-0545
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Country | US
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Telephone | 860-564-2709
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Fax | 860-564-4347
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Provider Business Mailing Address
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Address Line | P.O. BOX 545
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City | CENTRAL VILLAGE
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State | CT
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Zip | 06332-0545
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Country | US
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Telephone | 860-564-2709
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Fax | 860-564-4347
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 002311
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License Number State | CT
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