Provider Demographics
NPI:1124206198
Name:LITCHFIELD HILLS EYE PHYSICIANS, P.C.
Entity Type:Organization
Organization Name:LITCHFIELD HILLS EYE PHYSICIANS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:ETHEL
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:LO
Authorized Official - Phone:860-482-9399
Mailing Address - Street 1:333 KENNEDY DRIVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-7208
Mailing Address - Country:US
Mailing Address - Phone:860-482-9399
Mailing Address - Fax:860-482-0477
Practice Address - Street 1:333 KENNEDY DRIVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-7208
Practice Address - Country:US
Practice Address - Phone:860-482-9399
Practice Address - Fax:860-482-0477
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITCHFIELD HILLS EYE PYSICIANS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-01
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001240156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004143153Medicaid
100001240CT01OtherBCBS
0658210001Medicare NSC