Individual
MRS. KATHLEEN G DOMEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 BARNUM AVENUE CUT OFF, STRATFORD, CT 06614
(203) 502-7637
Mailing address
21 BELLE CIR, WEST HAVEN, CT 06516-7054
(203) 502-7637
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
CT 001614
CT
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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