Provider Demographics
NPI:1447385620
Name:FRITZ & HAWLEY VISION CENTER
Entity Type:Organization
Organization Name:FRITZ & HAWLEY VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:B
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:LO
Authorized Official - Phone:203-248-8224
Mailing Address - Street 1:2313 WHITNEY AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:203-248-8224
Mailing Address - Fax:203-248-8628
Practice Address - Street 1:2313 WHITNEY AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518
Practice Address - Country:US
Practice Address - Phone:203-248-8224
Practice Address - Fax:203-248-8628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT152W00000X, 156FC0801X
CT001362156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Not Answered156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens FitterGroup - Single Specialty
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0593160001Medicare ID - Type Unspecified