Jesse Collin Austin, LDO
Individual provider Active NPI Optician · Plainville, CT
NPI 1124865662 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1124865662
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 1913 (CT)
- Practice address
- 126 New Britain Ave Apt N2
Plainville, CT 06062-2035 - Phone
- (203) 578-0294
- NPI assigned
- Jul 11, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1913 | CT | Yes |
Addresses
Primary practice location
126 New Britain Ave Apt N2
Plainville, CT 06062-2035
Mailing address
126 New Britain Ave Apt N2
Plainville, CT 06062-2035
Phone (203) 578-0294
Other providers in Plainville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.