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Individual

DR. JESSE CHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
526 NEWFIELD AVE, STAMFORD, CT 06905-3746
(203) 327-1511
(203) 325-4479
Mailing address
526 NEWFIELD AVE, STAMFORD, CT 06905-3746
(203) 327-1511
(203) 325-4479

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002602
CT
152W00000X
Optometrist
VUT006536
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02592923
NY
Enumeration date
02/14/2006
Last updated
03/11/2013
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