Provider Demographics
NPI:1164947636
Name:HARTFORD EYE WELLNESS LLC
Entity Type:Organization
Organization Name:HARTFORD EYE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTAGNA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-871-6507
Mailing Address - Street 1:41 SUSAN DR
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-2538
Mailing Address - Country:US
Mailing Address - Phone:860-872-4045
Mailing Address - Fax:860-871-5765
Practice Address - Street 1:419 FRANKLIN AVE STE 102
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-2517
Practice Address - Country:US
Practice Address - Phone:860-871-6507
Practice Address - Fax:860-871-5765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty