Provider Demographics
NPI:1164622478
Name:PINKE EYE CENTER, LLC
Entity Type:Organization
Organization Name:PINKE EYE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-924-8800
Mailing Address - Street 1:9 COTS ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3866
Mailing Address - Country:US
Mailing Address - Phone:203-924-8800
Mailing Address - Fax:
Practice Address - Street 1:9 COTS ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3866
Practice Address - Country:US
Practice Address - Phone:203-924-8800
Practice Address - Fax:203-924-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC01047Medicare PIN
CT0494210001Medicare NSC