Organization
HENRY B SAMSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY BERNARD SAMSON O.D. (OWNER)
(203) 624-3896
Entity
Organization
Contact information
Practice address
100 YORK ST, SUITE 2K, NEW HAVEN, CT 06511-5620
(203) 624-3896
Mailing address
100 YORK ST, SUITE 2K, NEW HAVEN, CT 06511-5620
(203) 624-3896
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
769
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006518
CONNECTICARE
CT
01
—
0206420001
MEDICARE DMERC
CT
01
—
090000769CT02
ANTHEM BC/BS
CT
01
—
4143570-002
CIGNA
—
01
—
OVO398
HEALTHNET
CT
Enumeration date
01/26/2008
Last updated
01/26/2008
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