Individual
MR. EDWARD J MAMELOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LO
Contact information
Practice address
15 ARCADIA ROAD, OLD GREENWICH, CT 06870
(203) 698-2255
(203) 698-2655
Mailing address
15 ARCADIA ROAD, OLD GREENWICH, CT 06870
(203) 698-2255
(203) 698-2655
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
001192
CT
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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