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General NPI Number Information
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NPI Number | 1770710220
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Entity Type | Organization
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Legal Business Name | EDWARD S LIM, MD, LLC
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 144 N MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-3044
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Country | US
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Telephone | 203-643-0270
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Fax | 203-488-1104
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Provider Business Mailing Address
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Address Line | 144 N MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-3044
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Country | US
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Telephone | 203-643-0270
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Fax | 203-488-1104
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Authorized Official
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Title or Position | OWNER
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Name | EDWARD S LIM
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Credential | MD
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Telephone | 203-643-0270
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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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