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General NPI Number Information
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NPI Number | 1578696027
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Entity Type | Organization
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Legal Business Name | OCULUS, LLC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 460 MAIN ST LENSCRAFTERS
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2855
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Country | US
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Telephone | 860-343-6016
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Fax | 860-347-4797
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Provider Business Mailing Address
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Address Line | 460 MAIN ST LENSCRAFTERS
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2855
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Country | US
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Telephone | 860-343-6016
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Fax | 860-347-4797
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Authorized Official
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Title or Position | OPTOMETRIST OWNER
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Name | DR. SHARON HENDERSON
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Credential | OD
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Telephone | 860-409-4565
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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 |
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License Number State |
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