Organization
EYECARE CENTER OF WATERBURY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JOSEPH PULASKI OD (OPTOMETRIST)
(203) 754-8339
Entity
Organization
Contact information
Practice address
625 WOLCOTT ST, WATERBURY, CT 06705-1342
(203) 754-8339
Mailing address
625 WOLCOTT ST, WATERBURY, CT 06705-1342
(203) 754-8339
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
000910
CT
335E00000X
Prosthetic/Orthotic Supplier
000910
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004257673
—
CT
01
—
0043160
AETNA
CT
01
—
090000910CT01
BLUE CROSS
CT
01
—
115526
EYEMED
—
01
—
762224
CONNECTICARE
—
01
—
OV8953
HEALTHNET
—
01
—
P379072
OXFORD
—
Enumeration date
02/05/2007
Last updated
03/26/2008
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