Organization
PATRICIA YOUNGQUIST OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A YOUNGQUIST OD (MANAGER)
(203) 272-3342
Entity
Organization
Contact information
Practice address
120 COMMERCIAL PKWY, VISION CENTER, BRANFORD, CT 06405-2537
(203) 483-1901
(203) 488-3560
Mailing address
186 LANSDOWNE LN, CHESHIRE, CT 06410-1584
(203) 272-3342
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2200
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090002200CT15
BCBS
CT
01
—
11466814
CAQH
CT
01
—
118229
EYEMED
CT
01
—
2V6044
HEALTHNET
CT
05
—
411-8619
—
CT
01
—
687443
CONNECTICARE
CT
01
—
919749
BLOCK
CT
Enumeration date
01/05/2007
Last updated
08/22/2020
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