Provider Demographics
NPI:1851315170
Name:HOCHBERG, LOUIS G (OD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:G
Last Name:HOCHBERG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:
Practice Address - Street 1:2165 DIXWELL AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-2116
Practice Address - Country:US
Practice Address - Phone:203-407-3937
Practice Address - Fax:203-407-3932
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT090000947CT01OtherANTHEM BC/BS
CT601402OtherAETNA
CT410000329OtherMEDICARE
CT004050639Medicaid
CT566941OtherCONNECTICARE
CT566941OtherCONNECTICARE