Organization
THE EYE CARE GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL DULINA (CREDENTIALING COORDINATOR)
(203) 573-4803
Entity
Organization
Contact information
Practice address
22 OLD WATERBURY RD, SUITE 202, SOUTHBURY, CT 06488-3848
(203) 262-1600
(203) 401-6517
Mailing address
1201 W MAIN ST, SUITE 200, WATERBURY, CT 06708-3105
(203) 573-4885
(203) 401-6517
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
001664
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0352650003
NSC
CT
Enumeration date
11/08/2013
Last updated
05/24/2017
Update your record
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