Individual
DR. FREDRIC IVAN SMILEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
100 GREYROCK PL, STAMFORD, CT 06901-3118
(203) 348-3665
Mailing address
5 TIMBER LN, MONROE, CT 06468-2641
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CT2279
CT
152W00000X
Optometrist
T-005145-1
NY
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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