Individual
DR. MICHAEL V KALUSTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
30 6TH ST, STAMFORD, CT 06905-4610
(203) 357-7181
(203) 357-0632
Mailing address
30 6TH ST, STAMFORD, CT 06905-4610
(203) 357-7181
(203) 357-0632
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002585
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004223020
—
CT
Enumeration date
10/26/2006
Last updated
03/28/2012
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