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Organization

NORWICH OPHTHALMOLOGY OPTICAL

Active
Parent organization
NORWICH OPHTHALMOLOGY OPTICAL
Other names
EYE Q OPTICAL
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORWICH OPHTHALMOLOGY OPTICAL
Authorized official
DR. JEFFREY A. HERTZ M.D. (PRESIDENT)
(860) 886-0161
Entity
Organization

Contact information

Practice address
179 FLANDERS RD, NIANTIC, CT 06357-1203
(860) 447-8664
(860) 443-2986
Mailing address
179 FLANDERS RD, NIANTIC, CT 06357-1203
(860) 447-8664
(860) 443-2986

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
00562
CT
332H00000X
Eyewear Supplier
Primary
001058
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008002781
CT
01
100000433CT03
ANTHEM BLUE CROSS/SHIELD
CT
Enumeration date
04/02/2009
Last updated
02/16/2015
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