Organization
JOEL ROFFER, O.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL ROFFER O.D. (PRESIDENT)
(860) 678-8025
Entity
Organization
Contact information
Practice address
1600 S EAST RD, FARMINGTON, CT 06032-2610
(860) 678-8025
Mailing address
1600 S EAST RD, FARMINGTON, CT 06032-2610
(860) 678-8025
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
768
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410000251
MEDICARE PTAN
CT
Enumeration date
01/14/2012
Last updated
01/14/2012
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