Provider Demographics
NPI:1912942210
Name:HYDER, PAUL F (OD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:HYDER
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 1:83 QUARRY ST
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-1238
Mailing Address - Country:US
Mailing Address - Phone:860-423-1619
Mailing Address - Fax:860-423-1619
Practice Address - Street 1:83 QUARRY ST
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-1238
Practice Address - Country:US
Practice Address - Phone:860-423-1619
Practice Address - Fax:860-423-1619
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002268152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2071221OtherUNITED HEALTH CARE
CT090002268CT01OtherBLUE SHIELD CT
AA38466OtherHARVARD PILGRIM HEALTH
CT004192366Medicaid
0V5245OtherHEALTHNET
CT8585819OtherCIGNA
410000917OtherDMERC
P1292483OtherOXFORD
P1292483OtherOXFORD
2071221OtherUNITED HEALTH CARE