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General NPI Number Information
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NPI Number | 1700879004
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Entity Type | Organization
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Legal Business Name | GREENWICH OPHTHALMOLOGY ASSOC
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 4 DEARFIELD DR
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City | GREENWICH
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State | CT
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Zip | 06831-5351
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Country | US
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Telephone | 203-869-3082
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Fax | 203-869-6453
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Provider Business Mailing Address
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Address Line | 2046 W MAIN ST STE 2
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City | STAMFORD
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State | CT
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Zip | 06902-4523
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Country | US
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Telephone | 203-869-3082
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Fax | 203-869-6453
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | CHRISTINE BIRDSALL
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Credential |
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Telephone | 203-869-3082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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