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General NPI Number Information
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NPI Number | 1932309382
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Entity Type | Organization
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Legal Business Name | SOUTHINGTON EYE ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 318 NORTH MAIN STREET UNIT 2
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City | SOUTHINGTON
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State | CT
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Zip | 06489-0648
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Country | US
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Telephone | 860-621-4412
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Fax |
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Provider Business Mailing Address
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Address Line | 318 N MAIN ST STE 2D
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City | SOUTHINGTON
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State | CT
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Zip | 06489-2555
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Country | US
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Telephone | 860-621-4412
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Fax | 860-609-6005
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FARID FOUAD SHAFIK
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Credential | MD
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Telephone | 860-621-4412
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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 | 036594
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License Number State | CT
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