| Doctor Name: | GARY DENNIS HEINS |
| NPI Number: | 1033241997 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LICENSED OPTICIAN |
| License Number: | LO-# 715 |
| Business Practice Address: | 117 Washington Ave North Haven, CT - 064731769 |
| Business Phone Number: | 2032396172 |
| Business Fax Number: | 2032390295 |
| Mailing Address: | 117 Washington Ave, NORTH HAVEN |
| State: | CT |
| Postal Code: | 064731769 |
| Phone Number: | 2032396172 |
| Fax Number: | 2032390295 |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 07/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | LO-# 715 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |