Provider Demographics
NPI:1093739310
Name:STRAND, REGINA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:ANN
Last Name:STRAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 NORWICH NEW LONDON TURNPIKE
Mailing Address - Street 2:UNIT 8
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382
Mailing Address - Country:US
Mailing Address - Phone:860-848-8777
Mailing Address - Fax:860-848-3388
Practice Address - Street 1:2020 NORWICH NEW LONDON TURNPIKE
Practice Address - Street 2:UNIT 8
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382
Practice Address - Country:US
Practice Address - Phone:860-848-8777
Practice Address - Fax:860-848-3388
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2111152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004097764Medicaid
CT004097764Medicaid
CTT10633Medicare UPIN
CT0174890003Medicare NSC