Individual
RENITARUL SEBASTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
7550 JEWEL LN N, MAPLE GROVE, MN 55311-5458
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1
CT
Other
Enumeration date
04/30/2022
Last updated
04/30/2022
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