Organization
WESTVILLAGE OPTICIAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LUPI (OWNER)
(203) 397-1928
Entity
Organization
Contact information
Practice address
904 WHALLEY AVE, NEW HAVEN, CT 06515-1700
(203) 397-1928
Mailing address
904 WHALLEY AVE, NEW HAVEN, CT 06515-1700
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
L106
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0521380001
MEDICARE SUPPLIER NUMBER
CT
01
—
112900
EYEMED
CT
Enumeration date
05/01/2007
Last updated
01/12/2010
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