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General NPI Number Information
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NPI Number | 1689794851
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Entity Type | Organization
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Legal Business Name | PTC OPTICAL INC.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1330 BOSTON POST RD
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City | MILFORD
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State | CT
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Zip | 06460-2711
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Country | US
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Telephone | 203-877-6593
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Fax | 203-877-9139
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Provider Business Mailing Address
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Address Line | 1330 BOSTON POST RD
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City | MILFORD
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State | CT
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Zip | 06460-2711
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Country | US
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Telephone | 203-877-6593
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Fax | 203-877-9139
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Authorized Official
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Title or Position | LICENSED OPTICIAN & PRESIDENT
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Name | MR. THADDEUS BOJAR JR.
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Credential | L.O.
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Telephone | 203-877-6593
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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 | 000703
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License Number State | CT
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