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NPI 1710154711

NPI 1710154711 : HITCHCOCK MUNSON OPTICIANS : STAMFORD, CT

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General NPI Number Information
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    NPI Number           |    1710154711
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    Entity Type          |    Organization 
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    Legal Business Name  |    HITCHCOCK MUNSON OPTICIANS 
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Dates
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    Enumeration Date     |    05/09/2008
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    Last Update Date     |    08/01/2008
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Provider Practice Location Address
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    Address Line         |    75 HIGH RIDGE RD 
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    City                 |    STAMFORD
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    State                |    CT
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    Zip                  |    06905-3800
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    Country              |    US
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    Telephone            |    203-323-2181
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    75 HIGH RIDGE RD 
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    City                 |    STAMFORD
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    State                |    CT
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    Zip                  |    06905-3800
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    Country              |    US
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    Telephone            |    203-323-2181
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MR. HAROLD D MUNSON 
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    Credential           |    
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    Telephone            |    203-323-2181
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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       |    001175
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    License Number State |    CT
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