Provider Demographics
NPI:1003032210
Name:FRITZ, E. CRAIG (LO)
Entity Type:Individual
Prefix:MR
First Name:E.
Middle Name:CRAIG
Last Name:FRITZ
Suffix:
Gender:M
Credentials:LO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3126
Mailing Address - Country:US
Mailing Address - Phone:203-488-9900
Mailing Address - Fax:203-488-9900
Practice Address - Street 1:267 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3126
Practice Address - Country:US
Practice Address - Phone:203-488-9900
Practice Address - Fax:203-488-9900
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000552156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician