| Doctor Name: | MR. RAYMOND A. BOFFA |
| NPI Number: | 1538545124 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 000378 |
| Business Practice Address: | 532 Main St Branford, CT - 06405 |
| Business Phone Number: | 2034884743 |
| Business Fax Number: | |
| Mailing Address: | 532 Main St, BRANFORD |
| State: | CT |
| Postal Code: | 06405 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/05/2015 |
| NPI Last Update Date: | 08/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | 000378 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |