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Organization

CONNECTICUT EYE PHYSICIANS AND SURGEONS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD J MANGANIELLO M.D. (OWNER;/PROVIDER)
(860) 644-5011
Entity
Organization

Contact information

Practice address
479 BUCKLAND RD, SOUTH WINDSOR, CT 06074-3739
(860) 644-5011
(860) 644-4833
Mailing address
479 BUCKLAND RD STE A, SOUTH WINDSOR, CT 06074-3739
(860) 644-5011
(860) 644-4833

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
035387
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001353870
CT
Enumeration date
08/27/2007
Last updated
11/25/2024
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