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General NPI Number Information
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NPI Number | 1548670094
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Entity Type | Organization
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Legal Business Name | VEO VISION CENTER, LLC
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 240 INDIAN RIVER RD C-3
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City | ORANGE
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State | CT
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Zip | 06477-3649
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Country | US
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Telephone | 203-553-9794
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Fax |
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Provider Business Mailing Address
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Address Line | 240 INDIAN RIVER RD C-3
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City | ORANGE
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State | CT
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Zip | 06477-3649
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Country | US
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Telephone | 203-553-9794
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. RALPH M MIRTO
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Credential |
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Telephone | 203-553-9794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 001647
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License Number State | CT
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