Individual
DR. ANDREW DAVID STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1457 WHALLEY AVE, NEW HAVEN, CT 06515-1153
(203) 387-3937
(203) 389-3994
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2289
CT
Other
Enumeration date
01/30/2007
Last updated
03/17/2022
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