Provider Demographics
NPI:1811160989
Name:ROGER G TROIE
Entity type:Organization
Organization Name:ROGER G TROIE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:G
Authorized Official - Last Name:TROIE
Authorized Official - Suffix:
Authorized Official - Credentials:LO
Authorized Official - Phone:860-529-3937
Mailing Address - Street 1:415 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-2124
Mailing Address - Country:US
Mailing Address - Phone:860-529-3937
Mailing Address - Fax:860-529-0767
Practice Address - Street 1:415 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-2124
Practice Address - Country:US
Practice Address - Phone:860-529-3937
Practice Address - Fax:860-529-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0633650001Medicare NSC