Individual
JOHN T MACIEJEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2664 EAST MAIN STREET, BRIDGEPORT, CT 06610
(203) 333-4828
(203) 336-0049
Mailing address
2664 EAST MAIN STREET, BRIDGEPORT, CT 06610
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002045
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004087765
—
CT
Enumeration date
01/02/2007
Last updated
07/08/2007
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