Provider Demographics
NPI:1952396830
Name:FAIRFIELD COUNTY VISION CENTER INC
Entity Type:Organization
Organization Name:FAIRFIELD COUNTY VISION CENTER INC
Other - Org Name:HAMILTON OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:203-655-9571
Mailing Address - Street 1:553 POST RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-3609
Mailing Address - Country:US
Mailing Address - Phone:203-655-9571
Mailing Address - Fax:203-655-0774
Practice Address - Street 1:553 POST RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-3609
Practice Address - Country:US
Practice Address - Phone:203-655-9571
Practice Address - Fax:203-655-0774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTLO 447156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0164150001Medicare ID - Type Unspecified