Individual
DR. JERRY SAMUEL HARDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
553 FARMINGTON AVE, HARTFORD, CT 06105-3048
(860) 236-5831
(860) 236-2966
Mailing address
553 FARMINGTON AVE, HARTFORD, CT 06105-3048
(860) 236-5831
(860) 236-2966
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
851
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4024659
—
CT
Enumeration date
06/17/2005
Last updated
02/08/2008
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