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General NPI Number Information
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NPI Number | 1942010665
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Entity Type | Organization
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Legal Business Name | MIDDLESEX EYE PHYSICIANS P.C.
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 610 FOXON RD
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City | EAST HAVEN
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State | CT
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Zip | 06513-1967
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Country | US
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Telephone | 203-468-8800
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Fax | 203-458-9456
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Provider Business Mailing Address
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Address Line | 400 SAYBROOK RD STE 100
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4774
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Country | US
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Telephone | 860-347-7466
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Fax |
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | KRISTY G MASCARENHAS
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Credential | MD
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Telephone | 860-347-7466
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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 |
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License Number State |
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Taxonomy #2
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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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