Organization
DR. TAI NGUYEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAI NGUYEN (OWNER/OPTOMETRIST)
(860) 539-2010
Entity
Organization
Contact information
Practice address
90 ELM ST, TARGET OPTICAL, ENFIELD, CT 06082-3770
(860) 741-2020
Mailing address
2 LARKINS WAY, FARMINGTON, CT 06032-1723
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2547
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902937741
—
CT
Enumeration date
02/01/2016
Last updated
02/01/2016
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