MEDICARE: INSIGHT BY PHILIPS OPTICAL

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
1	156FX1800X	Optician	1014	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CT1014	OTHER	CT	EYEMED
2	50PHILIPOCT01	OTHER	CT	ANTHEM BLUE CROSS

General Provider Information

NPI Number	:	1194809285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHT BY PHILIPS OPTICAL

Provider Business Mailing Address
First Line	:	212 UNIVERSAL DRIVE
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-3233
Country	:	US
Telephone Number	:	203-239-0111
Fax Number	:	203-239-5556

Provider Business Practice Location Address
First Line	:	212 UNIVERSAL DR.
Second Line	:	212
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-3233
Country	:	US
Telephone Number	:	203-239-0111
Fax Number	:	203-239-5556

Authorized Official
Title or Position	:	OWNER
Name	:	MS. NANCY C;LAIRE MURPHY
Credential	:	LO1014
Telephone Number	:	203-239-0111

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/22/2020

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Directions to “INSIGHT BY PHILIPS OPTICAL ” Practice Location

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