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General NPI Number Information
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NPI Number | 1720975782
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Entity Type | Organization
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Legal Business Name | EYE DOCTOR OF CT PLLC
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 7 STONY HILL RD
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City | BETHEL
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State | CT
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Zip | 06801-1030
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Country | US
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Telephone | 203-794-0095
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Fax |
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Provider Business Mailing Address
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Address Line | 19 TROLLEY BRIDGE RD
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City | SHELTON
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State | CT
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Zip | 06484-5637
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Country | US
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Telephone | 971-336-6761
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | THAO NGUYEN
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Credential | O.D.
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Telephone | 971-336-6761
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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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