Individual
DR. HAL LAWRENCE OSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
116 E MAIN ST, UNIT 4, CLINTON, CT 06413-2120
(860) 669-2020
Mailing address
116 E MAIN ST, UNIT 4, CLINTON, CT 06413-2120
(860) 669-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2017
CT
152WC0802X
Corneal and Contact Management Optometrist
2017
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004130374
—
CT
01
—
0900002017CT02
ANTHEM
CT
01
—
0V0060
HEALTHNET
CT
01
—
512366
AETNA
CT
01
—
734485
CONNECTICARE
CT
01
—
P384312
OXFORD
CT
Enumeration date
06/02/2005
Last updated
01/10/2013
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