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NPI Code Detail

MEDICARE: DR. HOWARD SAUL GOTTLIEB O.D.

MEDICARE: DR. HOWARD SAUL GOTTLIEB 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
1152W00000XOptometrist707CT

General Provider Information

NPI Number : 1760421259
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HOWARD SAUL GOTTLIEB O.D.
Provider Business Mailing Address
First Line : 732 KYLE LN
Second Line :
City : WEST HAVEN
State : CT
Zip : 06516-7925
Country : US
Telephone Number : 203-494-6628
Fax Number : 203-389-2360
Provider Business Practice Location Address
First Line : 1201 BOSTON POST RD
Second Line : SEARS OPTICAL
City : MILFORD
State : CT
Zip : 06460-2703
Country : US
Telephone Number : 203-876-7005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 08/04/2009

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