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Organization
OPHTHALMIC SURGEONS OF GR BPT PC
Active
Organization
OPHTHALMIC SURGEONS OF GR BPT PC
Active
Other names
Optical Illusions
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN M SOBIERAJ (ADMINISTRATOR)
(203) 371-0141
Entity
Organization
Contact information
Practice address
2371 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3229
(203) 371-0141
(203) 371-6585
Mailing address
2371 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3229
(203) 371-0141
(203) 371-6585
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004001665
—
CT
Enumeration date
01/09/2007
Last updated
01/31/2008
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