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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