Provider Demographics
NPI:1598711723
Name:CONSULTING OPHTHALMOLOGISTS, P.C.
Entity Type:Organization
Organization Name:CONSULTING OPHTHALMOLOGISTS, P.C.
Other - Org Name:CONSULTING OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF HIT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MAZZOCCOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-678-0202
Mailing Address - Street 1:499 FARMINGTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1943
Mailing Address - Country:US
Mailing Address - Phone:860-678-0202
Mailing Address - Fax:860-678-0224
Practice Address - Street 1:499 FARMINGTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1943
Practice Address - Country:US
Practice Address - Phone:860-678-0202
Practice Address - Fax:860-678-0224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONSULTING OPHTHALMOLOGISTS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-26
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001553332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0714730001OtherMEDICARE DME
1598711723Medicare NSC
CT0714730001Medicare ID - Type Unspecified
1598711723Medicare PIN