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General NPI Number Information
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NPI Number | 1801932322
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Entity Type | Individual
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Provider Name | SUSAN WESTRUP O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 35 TOKENEKE RD
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City | DARIEN
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State | CT
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Zip | 06820-4605
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Country | US
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Telephone | 203-655-9044
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Fax |
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Provider Business Mailing Address
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Address Line | 399 MAIN AVE
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City | NORWALK
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State | CT
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Zip | 06851-1554
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Country | US
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Telephone | 203-644-4352
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Fax | 203-939-1424
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2050
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License Number State | CT
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