| Organization Name: | CONRAD W. KASACK, INC |
| NPI Number: | 1023168325 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOMINICK CHARLES VOLPE (PRESIDENT OPTICIAN) |
| Mailing Address: | 16 West St Danbury |
| State: | CT US |
| Postal Code: | 068107841 |
| Phone Number: | 2037433826 |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2007 |
| NPI Last Update Date: | 03/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 001268 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |