Organization
NORWICH OPTOMETRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS EDWARD WISNIEWSKI D.O. (OWNER)
(860) 886-1155
Entity
Organization
Contact information
Practice address
22 SALEM TURNPIKE, NORWICH, CT 06360-6516
(860) 886-1155
(860) 308-1505
Mailing address
22 SALEM TURNPIKE, NORWICH, CT 06360-6516
(860) 886-1155
(860) 308-1505
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002700
STATE LICENSE
CT
Enumeration date
04/25/2019
Last updated
10/13/2022
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