Provider Demographics
NPI:1922108091
Name:EYE CARE OF DANBURY LLC
Entity Type:Organization
Organization Name:EYE CARE OF DANBURY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAROODY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-790-8866
Mailing Address - Street 1:33 GERMANTOWN RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5013
Mailing Address - Country:US
Mailing Address - Phone:203-790-8866
Mailing Address - Fax:203-830-2013
Practice Address - Street 1:33 GERMANTOWN RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5013
Practice Address - Country:US
Practice Address - Phone:203-790-8866
Practice Address - Fax:203-830-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042474207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03304Medicare ID - Type UnspecifiedGROUP NUMBER