Organization
MY EYE SHOPPE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CLEMENT (MANAGER)
(203) 939-1880
Entity
Organization
Contact information
Practice address
650 MAIN AVE, NORWALK, CT 06851-1126
(203) 939-1880
Mailing address
650 MAIN AVE, NORWALK, CT 06851-1126
(203) 939-1880
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
156FX1800X
Optician
Primary
00408
CT
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008061865
—
CT
Enumeration date
01/12/2014
Last updated
11/06/2015
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