EYE SURGERY ASSOCIATES OPTICAL, LLC (NPI# 1184109332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184109332 |
| Entity Type | Organization |
| Organization Name | EYE SURGERY ASSOCIATES OPTICAL, LLC |
| Practice Address |
495 Hawley Ln Stratford CT 06614-1514 |
| Practice Telephone | 2033755819 |
| Mailing Telephone | 2033755819 |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2018-10-03 |
| Authorized Official Name | DR. BRIAN M DEBROFF (OWNER) |
| Authorized Official Telephone | 2033755819 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0132X |
Clinic/Center Specialization: Ophthalmologic Surgery |
Ambulatory Health Care Facilities |
| Street Address |
495 HAWLEY LN |
| City | STRATFORD |
| State | CT |
| Zip Code | 06614-1514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942294772 | Paul Gagne | Surgery | 495 Hawley Ln, Suite 2a, Stratford, CT 06614-1514 | 2005-09-08 |
| 1336615764 | Lee Robert Mckinney | Technician/Technologist | 495 Hawley Ln, Stratford, CT 06614-1514 | 2018-10-24 |
| 1962919605 | Katharina Ernst-sixto | Technician/Technologist | 495 Hawley Ln, Stratford, CT 06614-1514 | 2018-01-03 |
| 1114438652 | Eye Surgery Associates LLC | Technician/Technologist | 495 Hawley Ln, Stratford, CT 06614-1514 | 2017-10-23 |
| 1184867723 | Michael A Sergi | Surgery | 495 Hawley Ln, Suite 2a, Stratford, CT 06614-1514 | 2009-04-13 |
| 1114190154 | Vicente Antonio Diaz | Ophthalmology | 495 Hawley Ln, Stratford, CT 06614-1514 | 2008-04-10 |
| 1033318175 | Southern Connecticut Vascular Center, LLC | Surgery | 495 Hawley Ln, Suite 2a, Stratford, CT 06614-1514 | 2007-07-17 |
| 1164579181 | Lee J Goldstein | Surgery | 495 Hawley Ln, Suite 2a, Stratford, CT 06614-1514 | 2007-01-04 |
| 1205846243 | Marsel Huribal | Surgery | 495 Hawley Ln, Suite 2a, Stratford, CT 06614-1514 | 2006-08-09 |
| 1740245703 | Eye Surgery Associates LLC | Ophthalmology | 495 Hawley Ln, Stratford, CT 06614-1514 | 2006-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588139604 | David A Crosby | Physician Assistant | 125 Pumpkin Ground Road, Stratford, CT 06614 | 2018-10-04 |
| 1710489232 | Karen Marie Laconte | Naturopath | 720 Hilltop Dr, Stratford, CT 06614 | 2018-02-28 |
| 1972024693 | Amanda Wilson | Social Worker | 60 Edmund Street, Stratford, CT 06614 | 2017-07-03 |
| 1558801423 | Kristine Lynn Conlan | Physical Therapist | 55 Pasadena Ave., Stratford, CT 06614 | 2017-02-27 |
| 1811440258 | Seokwon Kwon | Dentist | 320 Boston Ave, Stratford, CT 06614 | 2016-08-02 |
| 1093176141 | Kathleen G Domek | Technician/Technologist | 150 Barnum Avenue Cut Off, Stratford, CT 06614 | 2016-03-17 |
| 1417328634 | Kelley Machado | Social Worker | 2127 Nichols Ave, Stratford, CT 06614 | 2015-10-14 |
| 1043629553 | Jennifer Woods-mesquita | Social Worker | 125 Greenlawn Ave, Stratford, CT 06614 | 2014-08-08 |
| 1437564010 | Jose R. Pacheco | Obstetrics & Gynecology | 120 Brightwood Ave, Stratford, CT 06614 | 2014-06-23 |
| 1740612829 | Stanley Brovender | General Practice | 773b Pontiac Lane, Stratford, CT 06614 | 2013-07-31 |
| Find all providers in zip 06614 | ||||
| Taxonomy Code | 261QS0132X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ophthalmologic Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700338738 | The Lasik Vision Institute LLC | Clinic/Center | 2313 Whitney Avenue, Suite 1b, Hamden, CT 06518 | 2016-10-25 |
| 1225174436 | Columbus Eye Associates | Clinic/Center | 1206 Silas Deane Hwy, Ste 2, Wethersfield, CT 06109-4328 | 2007-01-29 |
| 1689693970 | Connecticut Eye Surgery Center South LLC | Clinic/Center | 60 Wellington Rd, Milford, CT 06461-1677 | 2006-07-19 |
| 1043758022 | The Lasik Vision Institute LLC | Clinic/Center | 40 Richards Ave, 6th Floor, Norwalk, CT 06854-2319 | 2017-02-09 |
| 1225583420 | The Cataract Vision Institute LLC | Clinic/Center | 270 Farmington Ave, Suite 172, Farmington, CT 06032-1909 | 2016-08-18 |
| 1922442011 | The Lasik Vision Institute, LLC | Clinic/Center | 270 Farmington Ave, Suite 172, Farmington, CT 06032-1909 | 2013-04-19 |
| 1780835991 | Greenwich Ambulatory Surgery Center LLC | Clinic/Center | 55 Holly Hill Ln, Greenwich, CT 06830-6074 | 2008-10-07 |
| 1497940688 | Alan R. Ecker and Patricia A Ecker | Clinic/Center | 11 Woodland Rd, Madison, CT 06443-2342 | 2007-09-11 |
| 1710904537 | Constitution Eye Surgery Center LLC | Clinic/Center | 505 Willard Ave, Building 3, Newington, CT 06111-2650 | 2006-07-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.