Provider Demographics
NPI:1558918144
Name:AKBAR, AMARA (OD)
Entity Type:Individual
Prefix:
First Name:AMARA
Middle Name:
Last Name:AKBAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 ROXBURY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-1232
Mailing Address - Country:US
Mailing Address - Phone:203-586-9571
Mailing Address - Fax:
Practice Address - Street 1:921 ROXBURY RD
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-1232
Practice Address - Country:US
Practice Address - Phone:203-586-9571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3126152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist