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Individual

DAVID MICHAEL IMONDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
VA MEDICAL CENTER, 555 WILLARD AVENUE, NEWINGTON, CT 06111
(860) 667-6742
(860) 667-6833
Mailing address
57 BOURBON STREET, SOUTH WINDSOR, CT 06074
(860) 539-0584
(860) 652-3291

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002297
CT
152W00000X
Optometrist
02297
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4118833
CT
Enumeration date
03/17/2006
Last updated
03/11/2020
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