Individual
DR. MARK S FEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5 EVERSLEY AVE, SUITE 104, NORWALK, CT 06851-5821
(203) 853-1010
Mailing address
5 EVERSLEY AVE, SUITE 104, NORWALK, CT 06851-5821
(203) 853-1010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1047
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0177510001
DMERC NSC#
CT
01
—
090001047CT01
BLUE CROSS ID #
CT
01
—
090001047CT02
BLUE CROSS AS OF 2009
CT
01
—
1047
LICENSE NUMBER
CT
01
—
263271976
UHC
CT
01
—
P464831
OXFORD
CT
Enumeration date
10/13/2006
Last updated
03/12/2010
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