Individual
PATRICIA A YOUNGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
185 BOSTON POST RD, ORANGE, CT 06477-3200
(205) 795-5000
(203) 795-6685
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(038) 478-8997
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2200
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090002200CT15
BCBS
CT
01
—
11466814
CAQH
CT
01
—
118229
EYEMED
CT
01
—
2V6044
HEALTHNET
CT
01
—
364566194
UNITED
CT
05
—
411-8619
—
CT
01
—
687443
CONNECTICARE
CT
01
—
919749
BLOCK
CT
Enumeration date
01/05/2007
Last updated
03/25/2020
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