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Individual

DR. MARTIN ALAN MASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
86 PARK ST, HARTFORD, CT 06106-2524
(860) 728-5200
(860) 728-5203
Mailing address
33 SOUTHPOND RD, SOUTH GLASTONBURY, CT 06073-2326
(860) 728-5200
(860) 728-5203

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
000755
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004024139
CT
01
090000755CT02
BLUE CROSS & BLUE SHIELD
CT
Enumeration date
03/04/2007
Last updated
07/08/2007
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