MEDICARE: JOANA LALAJ

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	152W00000X	Optometrist	3404	CT
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1982408522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANA LALAJ

Provider Business Mailing Address
First Line	:	156 QUEEN ST
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-5853
Country	:	US
Telephone Number	:	323-217-6662
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 KING ST
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-9207
Country	:	US
Telephone Number	:	323-217-6662
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	11/11/2025

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Directions to “ JOANA LALAJ ” Practice Location

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