Provider Demographics
NPI:1316013766
Name:RAO, ANTHONY (OD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:RAO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:325 SORGHUM MILL DR
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3048
Mailing Address - Country:US
Mailing Address - Phone:203-250-7806
Mailing Address - Fax:203-374-3271
Practice Address - Street 1:5065 MAIN ST
Practice Address - Street 2:EYE GROUP, LLC
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4204
Practice Address - Country:US
Practice Address - Phone:203-374-3403
Practice Address - Fax:203-374-3271
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT2275152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU31135Medicare UPIN