Individual
CHARVEL LEE RENEE BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LO
Contact information
Practice address
433 S MAIN ST STE 103, WEST HARTFORD, CT 06110-2812
(860) 236-9004
Mailing address
185 BIRCHWOOD DR, NEW BRITAIN, CT 06052-1574
(860) 736-4438
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1701
CT
Other
Enumeration date
12/03/2020
Last updated
11/03/2025
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