Provider Demographics
NPI:1639947930
Name:CHILDRENS EYE CARE OF CONNECTICUT LLC
Entity Type:Organization
Organization Name:CHILDRENS EYE CARE OF CONNECTICUT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-371-7229
Mailing Address - Street 1:98 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1720
Mailing Address - Country:US
Mailing Address - Phone:860-453-0945
Mailing Address - Fax:
Practice Address - Street 1:98 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1720
Practice Address - Country:US
Practice Address - Phone:856-371-7229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus SpecialistGroup - Single Specialty