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1821261801 NPI number — STAMFORD VISION CARE.LLC

NPI Number: 1821261801
Health Care Provider/Practitioner: STAMFORD VISION CARE.LLC

Information about “1821261801” NPI (STAMFORD VISION CARE.LLC) exists in 1821261801 in HTML format HTML  |  1821261801 in plain Text format TXT  |  1821261801 in PDF (Portable Document Format) PDF  |  1821261801 in an XML format XML  formats.

NPI Number : 1821261801 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821261801",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "STAMFORD VISION CARE.LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "526 NEWFIELD AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "STAMFORD",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06905-3746",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "203-327-1511",
    "MailingAddressFaxNumber": "203-325-4479",
    "FirstLinePracticeLocationAddress": "526 NEWFIELD AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "STAMFORD",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06905-3746",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-327-1511",
    "PracticeLocationAddressFaxNumber": "203-325-4479",
    "EnumerationDate": "04/10/2008",
    "LastUpdateDate": "03/15/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DECARLO",
    "AuthorizedOfficialFirstName": "JOHN",
    "AuthorizedOfficialMiddleName": "P",
    "AuthorizedOfficialTitle": "OPTOMETRIST",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "O.D.",
    "AuthorizedOfficialTelephoneNumber": "203-327-1511",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": "704",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": "2021",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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