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Organization
CONNECTICUT RETINA CONSULTANTS LLC
Active
Organization
CONNECTICUT RETINA CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE IAN LARRISON M.D. (PARTNER/PHYSICIAN)
(203) 787-6161
Entity
Organization
Contact information
Practice address
46 PRINCE STREET, SUITE 203, NEW HAVEN, CT 06519-1600
(203) 787-6161
(203) 776-0300
Mailing address
46 PRINCE STREET, SUITE 203, NEW HAVEN, CT 06519-1600
(203) 787-6161
(203) 776-0300
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
03754
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001307546
—
CT
05
—
001337303
—
CT
05
—
001367300
—
CT
05
—
004203163
—
CT
01
—
180040406
RAILROAD MEDICARE
CT
01
—
180040407
RAILROAD MEDICARE
CT
01
—
180042135
RAILROAD MEDICARE
CT
01
—
CH2721
RAILROAD MEDICARE
CT
01
—
P00412496
MEDICARE RAIL ROAD
CT
Enumeration date
03/26/2007
Last updated
09/08/2023
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