Provider Demographics
NPI:1093693194
Name:D'AMORE, MARIA (LICENSED OPTICIAN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:D'AMORE
Suffix:
Gender:F
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 N MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2555
Mailing Address - Country:US
Mailing Address - Phone:860-621-4412
Mailing Address - Fax:860-609-6005
Practice Address - Street 1:318 N MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2555
Practice Address - Country:US
Practice Address - Phone:860-621-0560
Practice Address - Fax:860-609-6005
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001269156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician