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Individual

SARAH DOMEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LO

Contact information

Practice address
315 FOXON BLVD, NEW HAVEN, CT 06513-2355
(203) 467-7509
Mailing address
315 FOXON BLVD, NEW HAVEN, CT 06513-2355
(203) 467-7632
(203) 468-6851

Taxonomy

Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
1757
CT
156FX1800X
Optician
Primary
1757
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1285147645
CT
05
1757
CT
Enumeration date
11/08/2017
Last updated
05/23/2023
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