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NPI Code Detail

MEDICARE: GEORGE RAYMOND STIMAC O.D.

MEDICARE: GEORGE RAYMOND STIMAC O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist002513CT

General Provider Information

NPI Number : 1063484103
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE RAYMOND STIMAC O.D.
Provider Business Mailing Address
First Line : 35 DEREK LN
Second Line :
City : WINDSOR
State : CT
Zip : 06095-1739
Country : US
Telephone Number : 860-683-4490
Fax Number :
Provider Business Practice Location Address
First Line : 125 BUCKLAND HILLS DR
Second Line : @ TARGET OPTICAL
City : MANCHESTER
State : CT
Zip : 06042-8701
Country : US
Telephone Number : 860-327-0085
Fax Number : 860-327-0087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 07/08/2007

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Directions to “ GEORGE RAYMOND STIMAC O.D.” Practice Location

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