Individual
MR. EDWARD BEAUDETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.O.
Contact information
Practice address
2301 STATE ST, HAMDEN, CT 06517-3721
(203) 288-4905
(203) 288-4905
Mailing address
2301 STATE ST, HAMDEN, CT 06517-3721
(203) 288-4905
(203) 288-4905
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1001
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004054029
—
CT
01
—
100001001CT02
ANTHEM
—
01
—
CT1001
EYEMED
—
01
—
CU8360
HEALTHNET
—
Enumeration date
05/01/2007
Last updated
10/30/2008
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