Organization
CHIC BOUTIQUE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIZA YOUSSEFI OD (OWNER)
(203) 588-0100
Entity
Organization
Contact information
Practice address
168 BEDFORD ST, STAMFORD, CT 06901-1901
(203) 588-0100
(203) 588-9033
Mailing address
408 PITKIN HOLW, TRUMBULL, CT 06611-5612
(212) 470-5092
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
11/19/2018
Last updated
04/04/2019
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