Provider Demographics
NPI:1942701255
Name:RIDGEFIELD EYE PHYSICIANS & SURGEONS PLLC
Entity Type:Organization
Organization Name:RIDGEFIELD EYE PHYSICIANS & SURGEONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIRELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRASNIQI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-892-0222
Mailing Address - Street 1:38B GROVE ST STE LC
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4665
Mailing Address - Country:US
Mailing Address - Phone:917-892-0222
Mailing Address - Fax:
Practice Address - Street 1:38B GROVE ST STE LC
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4665
Practice Address - Country:US
Practice Address - Phone:917-892-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT054024207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Single Specialty