# OPHTHALMIC SURGEONS OF GR BPT PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Optical Illusions
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619026671
- **Authorized official:** MRS. KATHLEEN M SOBIERAJ (ADMINISTRATOR)
- **Authorized official phone:** (203) 371-0141

## Contact information

- **Practice address:** 2371 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3229
- **Practice address phone:** (203) 371-0141
- **Practice address fax:** (203) 371-6585
- **Mailing address:** 2371 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3229
- **Mailing address phone:** (203) 371-0141
- **Mailing address fax:** (203) 371-6585

## Taxonomy

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

## Other

- **Enumeration date:** 01/09/2007
- **Last updated:** 01/31/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004001665 | — | CT |