# CONNECTICUT EYE PHYSICIANS AND SURGEONS LLC

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

## Provider details

- **NPI number:** 1760675409
- **Authorized official:** DR. RICHARD J MANGANIELLO M.D. (OWNER;/PROVIDER)
- **Authorized official phone:** (860) 644-5011

## Contact information

- **Practice address:** 479 BUCKLAND RD, SOUTH WINDSOR, CT 06074-3739
- **Practice address phone:** (860) 644-5011
- **Practice address fax:** (860) 644-4833
- **Mailing address:** 479 BUCKLAND RD STE A, SOUTH WINDSOR, CT 06074-3739
- **Mailing address phone:** (860) 644-5011
- **Mailing address fax:** (860) 644-4833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 035387 | CT | Yes |

## Other

- **Enumeration date:** 08/27/2007
- **Last updated:** 11/25/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001353870 | — | CT |