Organization
STAMFORD VISION CARE.LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P DECARLO O.D. (OPTOMETRIST)
(203) 327-1511
Entity
Organization
Contact information
Practice address
526 NEWFIELD AVE, STAMFORD, CT 06905-3746
(203) 327-1511
(203) 325-4479
Mailing address
526 NEWFIELD AVE, STAMFORD, CT 06905-3746
(203) 327-1511
(203) 325-4479
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2021
CT
152W00000X
Optometrist
704
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090000704CT01
ANTHEM
CT
01
—
124217
UNITED HEALTHCARE
CT
01
—
4653930001
DME
CT
Enumeration date
04/10/2008
Last updated
03/15/2011
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