LEE ROBERT MCKINNEY (NPI# 1336615764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336615764 |
Entity Type | Individual |
Full Name | LEE ROBERT MCKINNEY |
Credential | LO |
Practice Address |
495 Hawley Ln Stratford CT 06614-1514 |
Practice Telephone | 2033755819 |
Practice Fax Number | 2033774337 |
Mailing Telephone | 2033755819 |
Mailing Fax Number | 2033774337 |
Enumeration Date | 2018-10-24 |
Last Update Date | 2018-10-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 156FX1100X |
Technician/Technologist Specialization: Ophthalmic |
1193 | CT | Eye and Vision Services Providers |
Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
1193 | CT | Eye and Vision Services Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | 1114438652 | 05 |
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 |
1184109332 | Eye Surgery Associates Optical, LLC | Clinic/Center | 495 Hawley Ln, Stratford, CT 06614-1514 | 2018-10-03 |
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 |
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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 | 156FX1800X |
Grouping | Eye and Vision Services Providers |
Classification | Technician/Technologist |
Specialization | Optician |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093176141 | Kathleen G Domek | Technician/Technologist | 150 Barnum Avenue Cut Off, Stratford, CT 06614 | 2016-03-17 |
1972689388 | Wal-mart Stores East, Lp | Technician/Technologist | 150 Barnum Ave. Cutoff, Stratford, CT 06614 | 2006-10-27 |
1962919605 | Katharina Ernst-sixto | Technician/Technologist | 495 Hawley Ln, Stratford, CT 06614-1514 | 2018-01-03 |
1013428754 | Alfredo A Angeles-puriaman | Technician/Technologist | 150 Barnum Avenue Cutoff, Stratford, CT 06614-5111 | 2017-10-21 |
1811448442 | Family Vision Center | Technician/Technologist | 775 Main St, Stratford, CT 06615-7406 | 2016-10-19 |
1063968915 | David Varker | Technician/Technologist | 150 Barnum Ave. Cutoff, Stratford, CT 06614 | 2016-08-31 |
1124572813 | Joseph Vanhoose | Technician/Technologist | 150 Barnum Avenue Cutoff, Stratford, CT 06614-5111 | 2016-08-10 |
1275761918 | Grover Opticians | Technician/Technologist | 2505 Main St, Stratford, CT 06615-5839 | 2009-07-01 |
1760616478 | Brian William Grover | Technician/Technologist | 2505 Main St, Stratford, CT 06615-5839 | 2009-05-08 |
1710946793 | Donna Trotta Linsley | Technician/Technologist | 3060 Main St, Stratford, CT 06614-4945 | 2006-03-20 |
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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.