Organization
OPHTHALMIC SURGEONS OF GR BPT PC
Active
Other names
Optical Illusions
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN M SOBIERAJ (ADMINISTRATOR)
(203) 371-0141
Entity
Organization
Contact information
Practice address
2371 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3229
(203) 371-0141
(203) 371-6585
Mailing address
2371 BLACK ROCK TPKE, FAIRFIELD, CT 06825-3229
(203) 371-0141
(203) 371-6585
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004001665
—
CT
Enumeration date
01/09/2007
Last updated
01/31/2008
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