| Doctor Name: | CARL KAMMERER |
| NPI Number: | 1043697352 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LO |
| License Number: | 000433 |
| Business Practice Address: | 79 Wawecus St Suite 105 Norwich, CT - 063602178 |
| Business Phone Number: | 8608893521 |
| Business Fax Number: | 8608895999 |
| Mailing Address: | 79 Wawecus St, Suite 105 NORWICH |
| State: | CT |
| Postal Code: | 063602178 |
| Phone Number: | 8608893521 |
| Fax Number: | 8608895999 |
| NPI Enumeration Date: | 05/06/2015 |
| NPI Last Update Date: | 05/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 000433 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |