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General NPI Number Information
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NPI Number | 1801840723
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Entity Type | Organization
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Legal Business Name | HAWLEY LANE OPTICIANS
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 100 HAWLEY LN
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City | TRUMBULL
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State | CT
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Zip | 06611-5330
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Country | US
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Telephone | 203-378-9462
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Fax | 203-380-9823
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Provider Business Mailing Address
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Address Line | 100 HAWLEY LN
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City | TRUMBULL
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State | CT
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Zip | 06611-5330
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Country | US
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Telephone | 203-378-9462
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Fax | 203-380-9823
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EDWARD AIMES
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Credential | L.O.
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Telephone | 203-378-9462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 001023
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 001023
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License Number State | CT
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