Individual
DR. SUSAN BARBARA JANIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1013 FARMINGTON AVE, WEST HARTFORD, CT 06107-2181
(860) 233-2020
(860) 236-9004
Mailing address
1013 FARMINGTON AVE, WEST HARTFORD, CT 06107-2181
(860) 233-2020
(860) 236-9004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002589
CT
152W00000X
Optometrist
4316
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004227147
—
CT
05
—
0336611
—
MA
01
—
400001480
MEDICARE
CT
01
—
410048374
MEDICARE RAILROAD
MA
01
—
W16316
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/01/2006
Last updated
12/14/2009
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