Doctor Name: | DR. STEVEN RICHARD SQUILLACE |
NPI Number: | 1265427983 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | O.D. |
License Number: | 3270 |
Business Practice Address: | 48 South Rd Unit 8 Somers, CT - 060712160 |
Business Phone Number: | 8607634733 |
Business Fax Number: | |
Mailing Address: | P.o. Box 801, SOMERS |
State: | CT |
Postal Code: | 060711206 |
Phone Number: | 8607634733 |
Fax Number: | |
NPI Enumeration Date: | 09/19/2005 |
NPI Last Update Date: | 03/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | 3270 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |