Individual
DR. MARK R CHASSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
160 WEST ST, CROMWELL, CT 06416-2441
(860) 635-6149
(860) 632-1401
Mailing address
160 WEST ST, CROMWELL, CT 06416-2441
(860) 635-6149
(860) 632-1401
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2893
MA
152W00000X
Optometrist
Primary
939
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090000939CT01
BLUE CROSS
—
01
—
4275439
AETNA
—
01
—
C01952
MEDICARE
—
Enumeration date
03/01/2006
Last updated
09/10/2007
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