Individual
HENRY B SAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
100 YORK ST, SUITE 2K, NEW HAVEN, CT 06511-5664
(203) 624-3896
(203) 777-2020
Mailing address
100 YORK ST, SUITE 2K, NEW HAVEN, CT 06511-5664
(203) 624-3896
(203) 777-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
769
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004024253
—
CT
01
—
006518
CONNECTICARE
CT
01
—
090000769CT03
ANTHEM BLUE CROSS/ BLUE SHIELD
CT
01
—
22-04198
UNITED HEALTHCARE
CT
01
—
4143570-002
CIGNA
CT
01
—
OVO398
HEALTHNET
CT
Enumeration date
08/04/2006
Last updated
11/19/2010
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