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Individual

MRS. KATHARINA ERNST-SIXTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICENSED OPTICIAN

Contact information

Practice address
495 HAWLEY LN, STRATFORD, CT 06614-1514
(203) 375-5819
(203) 377-4337
Mailing address
495 HAWLEY LN, STRATFORD, CT 06614-1514
(203) 375-5819
(203) 377-4337

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
001623
CT
332H00000X
Eyewear Supplier
Primary
001623
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1114438652
CT
Enumeration date
01/03/2018
Last updated
06/16/2018
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