Doctor Name: | STACY T CARLINO |
NPI Number: | 1417182551 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1566 |
Business Practice Address: | 161 Berlin Rd Cromwell, CT - 064161021 |
Business Phone Number: | 8606356221 |
Business Fax Number: | 8606329231 |
Mailing Address: | 161 Berlin Rd, CROMWELL |
State: | CT |
Postal Code: | 06416 |
Phone Number: | 8606356221 |
Fax Number: | 8606329231 |
NPI Enumeration Date: | 05/19/2009 |
NPI Last Update Date: | 05/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 1566 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |