Individual
DR. FABIAN CESAR VILLACIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1320 W MAIN ST STE 3, WATERBURY, CT 06708-3129
(203) 755-4941
(203) 573-8372
Mailing address
1320 W MAIN ST STE 3, WATERBURY, CT 06708-3129
(203) 755-4941
(203) 573-8372
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002832
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004195063 GR#
—
CT
05
—
8043102
—
CT
Enumeration date
06/15/2011
Last updated
09/30/2019
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