Individual
DR. TRACEY LYNN ASMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2691 BERLIN TPKE, NEWINGTON, CT 06111-4114
(860) 594-4585
(860) 667-4377
Mailing address
27 FOXTAIL RD, MIDDLETOWN, CT 06457-1770
(860) 632-8735
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002561
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11241145
CAQH
CT
Enumeration date
07/04/2006
Last updated
08/20/2012
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