Provider Demographics
NPI:1912011487
Name:SZCZEPANSKI, RAYMOND THOMAS (O D)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:THOMAS
Last Name:SZCZEPANSKI
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 771
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-0771
Mailing Address - Country:US
Mailing Address - Phone:203-795-5000
Mailing Address - Fax:203-795-6685
Practice Address - Street 1:185 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3200
Practice Address - Country:US
Practice Address - Phone:203-795-5000
Practice Address - Fax:203-795-6685
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0937152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT774875OtherCONNECTICARE
CT004138576Medicaid
CT090000937CT06OtherANTHEM B.C.B.S
CT061148751OtherUNITED HEALTHCARE
CTOV2093OtherHEALTHNET
CT090000937CT06OtherANTHEM B.C.B.S
CTOV2093OtherHEALTHNET