Provider Demographics
NPI:1750633392
Name:DR.HESSAM VAZIRI & ASSOCIATES LLC
Entity Type:Organization
Organization Name:DR.HESSAM VAZIRI & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HESSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZIRI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:617-447-5853
Mailing Address - Street 1:221 TRUMBULL ST
Mailing Address - Street 2:#1808
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06103-1500
Mailing Address - Country:US
Mailing Address - Phone:617-447-5853
Mailing Address - Fax:860-522-5577
Practice Address - Street 1:45 ASYLUM ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-2208
Practice Address - Country:US
Practice Address - Phone:860-522-2020
Practice Address - Fax:860-522-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002825152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty