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General NPI Number Information
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NPI Number | 1598711723
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Entity Type | Organization
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Legal Business Name | CONSULTING OPHTHALMOLOGISTS, P.C.
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 499 FARMINGTON AVE SUITE 100
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City | FARMINGTON
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State | CT
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Zip | 06032-1943
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Country | US
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Telephone | 860-678-0202
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Fax | 860-678-0224
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Provider Business Mailing Address
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Address Line | 499 FARMINGTON AVE SUITE 100
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City | FARMINGTON
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State | CT
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Zip | 06032-1943
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Country | US
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Telephone | 860-678-0202
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Fax | 860-678-0224
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Authorized Official
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Title or Position | DIRECTOR OF HIT
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Name | MARIA ANN MAZZOCCOLI
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Credential |
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Telephone | 860-678-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 001553
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License Number State | CT
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