Organization
CONNECTICUT VISION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA I DIAZ (OWNER/OPTOMETRIST)
(203) 469-1012
Entity
Organization
Contact information
Practice address
64 THOMPSON ST, SUITE B104, EAST HAVEN, CT 06513-5707
(203) 469-1012
(203) 467-1369
Mailing address
64 THOMPSON ST STE B104, EAST HAVEN, CT 06513-5701
(203) 469-1012
(203) 467-1369
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2426
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004173598
—
CT
Enumeration date
09/17/2008
Last updated
10/19/2010
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