# EYE CENTER OF SOUTHERN CONNECTICUT PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eye Center A Medical Surgical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528029634
- **Authorized official:** PAUL E MASI M.D. (PRESIDENT)
- **Authorized official phone:** (203) 248-6365

## Contact information

- **Practice address:** 2880 OLD DIXWELL AVE, HAMDEN, CT 06518-3144
- **Practice address phone:** (203) 248-6365
- **Practice address fax:** (203) 281-2742
- **Mailing address:** 2880 OLD DIXWELL AVENUE, HAMDEN, CT 06518
- **Mailing address phone:** (203) 248-6365
- **Mailing address fax:** (203) 281-2742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/29/2006
- **Last updated:** 10/05/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004067435 | — | CT |
| 01 | — | 0674910001 | PTAN | CT |