# EYE SURGICAL CONSULTANTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609013614
- **Authorized official:** DENISE LAVIN (OFFICE MANAGER)
- **Authorized official phone:** (203) 366-8000

## Contact information

- **Practice address:** 1064 EAST MAIN STREET, MERIDEN, CT 06450
- **Practice address phone:** (203) 237-1818
- **Practice address fax:** (203) 237-1819
- **Mailing address:** PO BOX 321088, FAIRFIELD, CT 06825-6088
- **Mailing address phone:** (203) 366-8000
- **Mailing address fax:** (203) 237-1819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 019681 | CT | Yes |

## Other

- **Enumeration date:** 01/13/2009
- **Last updated:** 01/13/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001196815 | — | CT |