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Individual

DR. JOHN NICHOLAS SIENKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
821 N MAIN STREET EXT, WALLINGFORD, CT 06492-2464
(203) 265-5152
(203) 265-1562
Mailing address
821 N MAIN STREET EXT, WALLINGFORD, CT 06492-2464
(203) 265-5152
(203) 265-1562

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
914
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004-08-1262
CT
Enumeration date
11/09/2006
Last updated
03/16/2010
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