Organization
MARINO OCULAR PROSTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS MARINO OCULARIST (OWNER)
(203) 284-3737
Entity
Organization
Contact information
Practice address
204 N COLONY ST, WALLINGFORD, CT 06492-3656
(203) 284-3737
(203) 284-1300
Mailing address
204 N COLONY ST, WALLINGFORD, CT 06492-3656
(203) 284-3737
(203) 284-1300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
48341408
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6623790001
MEDICARE PTAN
CT
Enumeration date
01/17/2012
Last updated
03/07/2012
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