Individual
REGINA D GENTILE JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
501 BOSTON POST RD, ORANGE, CT 06477
(203) 795-3937
(203) 891-0737
Mailing address
501 BOSTON POST RD, ORANGE, CT 06477
(203) 795-3937
(203) 891-0737
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CT840
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004068391
—
CT
Enumeration date
11/07/2006
Last updated
11/16/2011
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