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NPI Code Detail

MEDICARE: ROGER A MOORE OPTOMETRIST

MEDICARE: ROGER A MOORE OPTOMETRIST
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
1152W00000XOptometrist950CT

General Provider Information

NPI Number : 1518135672
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROGER A MOORE OPTOMETRIST
Provider Business Mailing Address
First Line : 14 CHURCH HILL RD # C10
Second Line :
City : NEWTOWN
State : CT
Zip : 06470-1640
Country : US
Telephone Number : 203-426-2727
Fax Number : 203-426-5113
Provider Business Practice Location Address
First Line : 14 CHURCH HILL RD # C10
Second Line :
City : NEWTOWN
State : CT
Zip : 06470-1640
Country : US
Telephone Number : 203-426-2727
Fax Number : 203-426-5113
Authorized Official
Title or Position : OWNER
Name : DR. ROGER A. MOORE
Credential : O.D.
Telephone Number : 203-426-2727
Provider Enumeration Date : 02/12/2008
Last Update Date : 03/11/2011

Similar Medicare Providers

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Practice Location Address:
14 CHURCH HILL RD
NEWTOWN, CT
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Practice Fax:
1780394288 — NGUYEN EYE CARE
Practice Location Address:
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Directions to “ROGER A MOORE OPTOMETRIST ” Practice Location

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