Provider Demographics
NPI:1164630703
Name:COHENS FASHION OPTICAL
Entity Type:Organization
Organization Name:COHENS FASHION OPTICAL
Other - Org Name:WOODMONT OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:AARONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-787-2020
Mailing Address - Street 1:1201 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-2703
Mailing Address - Country:US
Mailing Address - Phone:203-878-2020
Mailing Address - Fax:203-878-1783
Practice Address - Street 1:1201 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-2703
Practice Address - Country:US
Practice Address - Phone:203-878-2020
Practice Address - Fax:203-878-1783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001332305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service