Provider Demographics
NPI:1366641680
Name:ALLING, JEAN-MARC (OD)
Entity Type:Individual
Prefix:DR
First Name:JEAN-MARC
Middle Name:
Last Name:ALLING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-5021
Mailing Address - Country:US
Mailing Address - Phone:718-986-8495
Mailing Address - Fax:
Practice Address - Street 1:115 OLD RIDGEFIELD RD STE 101B
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3019
Practice Address - Country:US
Practice Address - Phone:203-834-0860
Practice Address - Fax:203-762-3876
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007189152W00000X
CT2740152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist