Organization
SHORELINE EYE ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD LEE DISTELMAN M.D. (PRESIDENT)
(203) 453-3100
Entity
Organization
Contact information
Practice address
515 BOSTON ST, GUILFORD, CT 06437-2960
(203) 453-3100
Mailing address
515 BOSTON ST, GUILFORD, CT 06437-2960
(203) 453-3100
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180033273
RAILROAD
CT
Enumeration date
05/11/2007
Last updated
04/09/2008
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