Organization
MARVIN A SODERGREN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN ARNOLD SODERGREN O.D. (OPTOMETRIST/OWNER)
(860) 456-7426
Entity
Organization
Contact information
Practice address
850 HARTFORD TPKE, WATERFORD, CT 06385-4238
(860) 444-7441
(860) 444-1800
Mailing address
6 PIGEON SWAMP RD, LEBANON, CT 06249-1333
(860) 456-7425
(860) 456-7425
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
000714
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004023800
—
CT
01
—
1750364436
NPI
—
Enumeration date
03/15/2010
Last updated
03/15/2010
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