Provider Demographics
NPI:1730501651
Name:FAYMAR OPTICAL INC
Entity Type:Organization
Organization Name:FAYMAR OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALGRANATI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:203-249-5042
Mailing Address - Street 1:7 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4305
Mailing Address - Country:US
Mailing Address - Phone:203-249-5042
Mailing Address - Fax:
Practice Address - Street 1:7 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4305
Practice Address - Country:US
Practice Address - Phone:203-249-5042
Practice Address - Fax:203-762-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2209152W00000X, 152WC0802X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Single Specialty